Associations between serum total, free and bioavailable testosterone and non-alcoholic fatty liver disease in community-dwelling middle-aged and elderly women - 01/11/20

Doi : 10.1016/j.diabet.2020.09.007

Xu Wang ^a,^b, Qing Li ^a,^b, Juan Pang ^a,^b, Jiesheng Lin ^b,^c, Yao Liu ^a,^b, Zhongliang Xu ^a,^b, Hanyue Zhang ^a,^b, Tianran Shen ^a,^b, Xu Chen ^a,^b, Jing Ma ^a,^b, Xiping Xu ^d, Wenhua Ling ^a,⁎ , Yuming Chen ^b,^⁎
^a Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province 510080, PR China
^b Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Guangzhou, Guangdong Province 510080, PR China
^c Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province 510080, PR China
^d Guangdong Engineering Technology Centre of Nutrition Transformation, Guangzhou, Guangdong Province 510080, PR China

^⁎Corresponding author at: Department of Nutrition, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd. 2, Guangzhou, Guangdong Province 510080, PR China.Department of Nutrition, School of Public Health, Sun Yat-sen University74 Zhongshan Rd. 2GuangzhouGuangdong Province510080PR China^⁎⁎Corresponding author at: Department of Epidemiology, School of Public Health, Sun Yat-sen University, 74 Zhongshan Rd. 2, Guangzhou, Guangdong Province 510080, PR China.Department of Epidemiology, School of Public Health, Sun Yat-sen University74 Zhongshan Rd. 2GuangzhouGuangdong Province510080PR China

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Abstract

Background and aims

Non-alcoholic fatty liver disease (NAFLD) is considered both a cause and consequence of the metabolic syndrome (MetS). While emerging evidence has indicated that testosterone is associated with MetS, the relationship between testosterone and NAFLD in women remains unclear. Therefore, this study investigated the associations between serum testosterone levels and NAFLD prevalence risk in a community-based cross-sectional study.

Methods

A total of 2117 adult women were included in the analysis. Serum total testosterone (TT) was measured by chemiluminescence immunoassay, and other testosterone-related indices, such as concentrations and percentages of calculated free testosterone (cFT) and bioavailable testosterone (BioT), and free androgen index (FAI), were also calculated. NAFLD was diagnosed by clinical criteria. Logistic regression was used to explore these associations.

Results

There were significant differences in TT, FAI, cFT and BioT between women with and without NAFLD (all P<0.001). Multivariate logistic-regression analyses demonstrated that both absolute concentrations and percentages of cFT and BioT were positively associated with NAFLD risk prevalence in all models. Adjusted ORs (95% CI) for quartile 4 vs quartile 1 of % cFT and % BioT were 5.94 (4.29–8.22) and 5.21 (3.79–7.17) in model 2, and 4.35 (3.07–6.18) and 3.58 (2.55–5.03) in model 3 (all P<0.001 for trend). In addition, quartiles of TT, FAI, cFT and BioT were significantly correlated with degree of hepatic steatosis. ROC analysis also showed that % cFT and % BioT were more accurate for predicting NAFLD prevalence than was TT.

Conclusion

Serum cFT and BioT were positively associated with NAFLD risk, and elevated levels of cFT and BioT could be independent risk factors of NAFLD prevalence in middle-aged and elderly women.

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Abbreviations : NAFLD, TT, ALT, PCOS, SHBG, FAI, cFT, BioT, TG, TC, HDL-C, LDL-C, AST, ALP, UA, hsCRP, HOMA, IR, BMI, WHR, ROC, AUROC, CI, OR