A low level of serum total testosterone is independently associated with nonalcoholic fatty liver disease

Abstract

BackgroundThe association between low serum testosterone levels, visceral adipose tissue (VAT), and metabolic syndrome is now well known. However, the relationship between hepatic steatosis and serum testosterone levels has not been extensively studied. Our aim was to investigate the association of serum total testosterone levels with nonalcoholic fatty liver disease (NAFLD), adjusting for the influence of VAT and insulin resistance.MethodsThis study is a retrospective observational cross-sectional one of healthy Korean men and was conducted at the Seoul National University Hospital Healthcare System Gangnam Center. We used data obtained from 495 men who were at least 20 years of age and who had undergone blood testing, abdominal computed tomography, and ultrasonography. Multiple logistic regression analysis was used to explore the association of serum total testosterone levels with NAFLD.ResultsMen in the low serum testosterone quintile were at a higher risk for NAFLD than men in the highest serum testosterone quintile. After adjusting for age, smoking, diabetes, exercise, BMI, triglycerides, and high-density-lipoprotein cholesterol, subjects with serum testosterone levels in the lowest quintile had an odds ratio (OR) (95% confidence interval (CI)) of 5.12 (2.43–10.77) for NAFLD (p value, 0.0004). The inverse association between serum testosterone and NAFLD was attenuated by further adjustment for variables including VAT; however, it remained statistically significant (OR (95% CI): 4.52 (2.09–9.80) in the lowest quintile; p value=0.004).ConclusionsA low serum total testosterone level was independently associated with NAFLD. This report is the first one suggesting the association remains unchanged even after controlling for VAT and insulin resistance.

Nonalcoholic fatty liver disease is a negative risk factor for prostate cancer recurrence

“…Second, it is well accepted that prostate cancer is a testosterone-dependent malignancy. Recent observational studies have showed that a low serum total testosterone level is independently associated with NAFLD regardless of visceral adipose tissue and insulin resistance (Völzke et al 2010, Kim et al 2012. In our study, consistent with previous findings, we could measure serum testosterone in 76 patients (28 patients with NAFLD and 48 patients without NAFLD) after excluding patients treated with androgen deprivation therapy (ADT).…”

Body compositional and cardiometabolic effects of testosterone therapy in obese men with severe obstructive sleep apnoea: a randomised placebo-controlled trial

“…Both reported reductions in metabolic syndrome but were of longer duration (1-2 years) and both specifically recruited men with metabolic syndrome. However, no studies thus far have targeted reversal of NAFLD despite an independent association between low testosterone levels and hepatic steatosis, a marker for NAFLD (60,61). The prevalence of NAFLD is increasing, particularly in patients with cardiometabolic risk factors and is associated with increased risk of liver damage and possibly future CVD (52,62).…”

Genetic and hormonal control of hepatic steatosis in female and male mice

“…Both human and rodent studies provide evidence for a protective effect of estrogen and testosterone on the development of fatty liver (15)(16)(17)(19)(20)(21). We set out to investigate the effect of gonadectomy in three different strains of both sexes.…”

“…The fact that breast cancer patients treated with an estrogen receptor antagonist develop massive hepatic steatosis and even typical NASH indicates that estrogen affects development of this disease (16). Cross-sectional studies assessing the association between plasma testosterone and NAFLD have shown conflicting results (17)(18)(19). However, rodent studies have shown that both estrogen and testosterone can have an inhibitory effect on liver lipid accumulation (20,21).…”