The association of sex steroid hormone concentrations with non-alcoholic fatty liver disease and liver enzymes in US men

Hong Phan, Aline Richard, Mariana Lazo, William G. Nelson, Samuel R. Denmeade, John Groopman, Norma Kanarek, Elizabeth A. Platz, Sabine Rohrmann

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background & Aims: This study aimed to analyse the association of sex hormone levels with liver enzyme levels and non-alcoholic fatty liver disease (NAFLD) in a nationally representative sample of men. Methods: A total of 919 men from the US National Health and Nutrition Examination Study (NHANES) III were included in this cross-sectional analysis of data from 1988 to 1991. We used existing data on serum total and free testosterone, total and free estradiol, androstanediol glucuronide (AAG) and sex steroid-binding globulin (SHBG), and estimated their associations with aspartate aminotransferase (AST), and alanine aminotransferase (ALT) and NAFLD, as determined using ultrasound, after adjusting for possible confounders including age, race, smoking, alcohol, physical activity, waist circumference and steroid hormones. Results: Lower total testosterone (TT) and higher free estradiol were associated with higher odds of NAFLD after adjusting for confounders including the other sex hormones. Lower TT was associated with higher odds of elevated AST, but not ALT. Free testosterone, total estradiol, SHBG and AAG were not associated with NAFLD or liver enzymes. Conclusions: This study supports an inverse association between TT concentration and NAFLD in men independent of other sex hormones (SHBG, AAG and estradiol) and known risk factors, such as obesity, age and lifestyle. Exploration of whether TT might be a non-invasive marker for NAFLD diagnosis is warranted.

Original languageEnglish (US)
Pages (from-to)300-310
Number of pages11
JournalLiver International
Volume41
Issue number2
DOIs
StatePublished - Feb 2021

Keywords

  • estradiol
  • hepatic steatosis
  • non-alcoholic fatty liver disease
  • sex hormone-binding globulin
  • testosterone

ASJC Scopus subject areas

  • Hepatology

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