Plasma renin substrate sensitivity to oestrogens and oestrogen metabolism in cirrhosis

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Abstract
Estrogen stimulation of plasma renin substrate (PRS) was studied in men with alcoholic cirrhosis. PRS values, before and 1, 2, 4 and 6 days after a single oral administration of 100 .mu.g of an estrogen derivative, 11.beta.-methoxy-17-ethynyl-1,3,5(10)-estratriene-3,17.beta.-diol (Moxestrol), were measured by radioimmunoassay of generated angiotensin I in 5 men with normal liver function and 5 men with alcoholic cirrhosis. Basal PRS was 0.93 .+-. 0.22 nmol/ml in the normal men and significantly lower (P < 0.01) in the men with cirrhosis (0.33 .+-. 0.14 nmol/ml). Two days after administration of Moxestrol, PRS rose significantly but transiently (P < 0.05) to 1.41 .+-. 0.42 nmol/ml in the normal men and to 0.47 .+-. 0.15 in the cirrhotic men, the relative increase (.apprx. 50%) being similar in both groups. A study of the plasma kinetics and urinary excretion of Moxestrol was also performed to evaluate its metabolic clearance rate and absorption. Since the intestinal absorption of [14C]Moxestrol was not depressed in cirrhotic men, the low PRS values recorded are probably the consequence of hepatocyte dysfunction.