الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 90 |  |  |
| | | from | 90 | | |
Abstract
Liver cirrhosis is a progressive irreversible process and it is the final common pathway for a variety of liver diseases as viral hepatitis, alcoholic hepatitis, autoimmune and cholestatic hepatitis.
Liver is the primary site for metabolism of adrenal steroid hormones and synthesis of cholesterol which is needed in steroidogensis, therefore the preexisting liver dysfunction may disrupt the activation of hypothalamic pituitary axis and also several factors and consideration are associated with alter hepatic metabolism of cortisol including hormones, gender, age, obesity, diseases and drugs.
Cortisol is a steroid hormone synthesized from cholesterol in the zona fasciculate of the adrenal gland .Cortisol is essential for life as it has an important role in regulating blood pressure, cardiovascular functions, metabolism (anabolic in liver and catabolic in fat and muscle),anti-inflammatory and affects mood and behavior.
Cortisol consists of 10% active free part and 90% protein pound part. This protein pound part is 60% pounded to corticosteroid binding globulin (CBG) and 30%pounded to albumin. Corticosteroid binding globulin (CBG) main action to deliver cortisol after its synthesis in the adrenal gland to target tissues. Corticosteroid binding globulin (CBG) binds to cortisol with higher affinity but low capacity while albumin binds with low affinity but an infant capacity for cortisol .
Hypoalbuminemia or decreased corticosteroid binding globulin (CBG) will affect the level the total serum cortisol so using salivary cortisol as reflection to the active free part of cortisol in cirrhotic patients as they have reduction of all synthetic function of liver including protein synthesis as albumin, transfertin and haptoglobin.