ReviewJournal of the Endocrine Society2022
Adrenal Insufficiency in Cirrhosis.
Review in Journal of the Endocrine Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Relative adrenal insufficiency in the non-critically ill patient with cirrhosis: A systematic review and meta-analysis.Liver international : official journal of the International Association for the Study of the Liver · 2023Pooled it
- Low-Dose Hydrocortisone in Cirrhotic Patients With Septic Shock: A Double-Blind Randomised Placebo-Controlled Trial.Liver international : official journal of the International Association for the Study of the Liver · 2025Trial
- Liver cirrhosis is associated with altered glucocorticoid metabolism related to disease severity.Journal of internal medicine · 2026Article
- Severe hypercalcemia in a patient with end-stage liver disease.JCEM case reports · 2026Article
- Adrenal Dysfunction in Outpatients with Decompensated Cirrhosis: Impairment in the Hypothalamic-Pituitary-Adrenal Axis.Digestive diseases and sciences · 2025Article
- Article
- Interplay between endocrine disorders and liver dysfunction: Mechanisms of damage and therapeutic approaches.World journal of gastroenterology · 2025Review
- Gut Microbiome-Liver-Brain axis in Alcohol Use Disorder. The role of gut dysbiosis and stress in alcohol-related cognitive impairment progression: possible therapeutic approaches.Neurobiology of stress · 2025Article
- Liver impairment and medical management of Cushing syndrome and MACS.Frontiers in endocrinology · 2025Review
- Joint Group and Multi Institutional Position Opinion: Cirrhotic Cardiomyopathy-From Fundamentals to Applied Tactics.Medicina (Kaunas, Lithuania) · 2024Review
- From liver to hormones: The endocrine consequences of cirrhosis.World journal of gastroenterology · 2024Review
- An impaired pituitary-adrenal signalling axis in stable cirrhosis is linked to worse prognosis.JHEP reports : innovation in hepatology · 2023Article
- Endocrinology for the hepatologist.Clinical liver disease · 2023Article
- Review article: Practical considerations for fluid resuscitation in cirrhosis.Alimentary pharmacology & therapeutics · 2023Review
- Emerging concepts in the care of patients with cirrhosis and septic shock.World journal of hepatology · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
Abstract
Hypothalamus-pituitary-adrenal axis assessment in patients with cirrhosis is challenging. The phenotype of fatigue, hypotension, electrolyte disarray, and abdominal pain characterizing primary adrenal insufficiency (AI) overlaps significantly with decompensated liver disease. Reliance on total cortisol assays in hypoproteinemic states is problematic, yet abnormal stimulated levels in cirrhosis are associated with poor clinical outcomes. Alternative measures including free plasma or salivary cortisol levels have theoretical merit but are limited by unclear prognostic significance and undefined cirrhosis-specific reference ranges. Further complicating matters is that AI in cirrhosis represents a spectrum of impairment. Although absolute cortisol deficiency can occur, this represents a minority of cases. Instead, there is an emerging concept that cirrhosis, with or without critical illness, may induce a "relative" cortisol deficiency during times of stress. In addition, the limitations posed by decreased synthesis of binding globulins in cirrhosis necessitate re-evaluation of traditional AI diagnostic thresholds.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.