الفهرس 
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Abstract
The aim of the present work was to assess the correlation between
serum testosterone level and sarcopenia in Egyptian male patients with
liver cirrhosis.
This study was conducted on 60 males with liver cirrhosis. Patients
were selected from inpatient and outpatient clinic of Tropical Medicine
Department, Menofia University Hospital and the Hepatology
Department, Al haram Specialized Hospital in the period between June
2016 to December 2016. Their age ranged from 33 to 57 years with a
mean age of 46.5 ± 6.53 years. As well as 20 healthy males of matched
age and sex were included in the study as a control group.
Patients and controls were classified into the following groups:
group I: Included 60 patients with liver cirrhosis. They were
subdivided according to child-Pugh classification into:
group Ia: Included 20 Child-Pugh A cirrhotic patients.
group Ib: Included 20 Child-Pugh B cirrhotic patients.
group Ic: Included 20 Child-Pugh C cirrhotic patients.
group II: Included 20 healthy Subjects as a control group .
For this purpose, all patients were subjected to the following:
Complete history taking, complete clinical examinations and full
investigations including: Complete blood count, liver function tests,
serological tests for viral hepatitis markers as HbsAg and HCV Ab,
kidney function tests, elecrolytes, Serum total & free testosterone,
abdominal ultrasonography and CT scans of Para spinal skeletal muscle
at the level of the 3rd lumbar vertebral body (L3 SMI).
Statistical analysis of the presenting data revealed:
There was no statistical significant difference between the studied
groups regarding age.
There was high statistical significance difference between studied
groups regarding history of hematemesis and/or melena and hepatic
encephalopathy. There was statistical significance difference as
regard edema of the lower limb, jaundice and muscle wasting . On the
other hand there was no statistical significance difference as regard
the presence of palmer erythema and spider naevi .
Local abdominal examination revealed that there was statistical
significance difference between studied subgroups regarding the presence
of gynecomastia , hernia, feminine pelvic hair distribution as well as the
size of liver & spleen and the amount of ascites .
There was statistical significant difference between the studied
groups as regard BMI (measured using estimated dry weight ). It was
lower in cirrhotic patients than control with the lowest value in child
C cirrhotic group (GIc).
There was high statistical significance difference between studied
groups regarding hemoglobin concentration & platelet count . On the
other hand there was no statistical significant differences between
study groups as regard Total leucocytic count.
There was high statistical significance difference between studied
groups regarding ALT, INR , serum albumin, T.bilirubin and serum
sodium concentration (P<0.001).
There was highly statistical significant differences between cirrhotic
patients regarding MELD score with the highest score in child c
(GIc) .
There was no statistical significantly difference regarding the
etiology of cirrhosis , chronic HCV was the commonest cause of
cirrhosis in all patients groups.
There was high statistical significant difference among all studied
groups regarding free and total testosterone levels with the lowest
levels in child-C cirrhotic patients There was high statistical significant difference among studied
groups regarding size of liver and spleen, portal vein dilatation and
the amount of ascites (P<0.001).
There was high statistical significant difference among studied
groups regarding SMI with the lowest level in child-C cirrhotic
patients. The presence of sarcopenia was significantly different
among studied groups. It was not detected in control groups , and
significantly increased with increasing child score from A to B and
highest in child-C cirrhotic patients (P= 0.001).
At cutoff point 14.1 nmol/L total testosterone level has Sensitivity
91% , Specificity 94% and Accuracy 93.0% in diagnosis of
sarcopenia in cirrhotic patients.
There was high significant positive correlation between serum total
testosterone and Skeletal muscle index (SMI).
There was high significant positive correlation between serum total
testosterone and Age, BMI, Hb, Serum albumin, Na &PLT in
cirrhotic patients. There was high significant negative correlation
between total testosterone and MELD scores, INR & Bilirubin in
cirrhotic patients.
There was high significant positive correlation between skeletal
muscle index and S. albumin, Na & PLT in cirrhotic patients. There
was high significant negative correlation between skeletal muscle
index and MELD scores, INR,ALT & Bilirubin in cirrhotic patients