Severity of non-alcoholic steatohepatitis is not linked to testosterone concentration in patients with type 2 diabetes.

<h4>Background</h4>Hypogonadism is reported to occur in non-alcoholic fatty liver disease (NAFLD), but earlier studies used low-sensitivity diagnostic techniques (CT, ultrasound), for NAFLD diagnosis. We hypothesized that if hypogonadism was due to NAFLD, and not solely attributable to u...

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Main Authors: Kristin Alexandra Dayton, Fernando Bril, Diana Barb, Jinping Lai, Srilaxmi Kalavalapalli, Kenneth Cusi
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0251449
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spelling doaj-a21b9e6913004e2a81f3a4e994607c9a2021-06-19T05:08:41ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01166e025144910.1371/journal.pone.0251449Severity of non-alcoholic steatohepatitis is not linked to testosterone concentration in patients with type 2 diabetes.Kristin Alexandra DaytonFernando BrilDiana BarbJinping LaiSrilaxmi KalavalapalliKenneth Cusi<h4>Background</h4>Hypogonadism is reported to occur in non-alcoholic fatty liver disease (NAFLD), but earlier studies used low-sensitivity diagnostic techniques (CT, ultrasound), for NAFLD diagnosis. We hypothesized that if hypogonadism was due to NAFLD, and not solely attributable to underlying obesity/diabetes, it would be more severe in the presence of steatohepatitis (NASH). To examine the influence of liver disease on testosterone in males with type 2 diabetes mellitus (T2DM), we used gold-standard liver imaging with MR-spectroscopy (1H-MRS), and performed liver biopsies to grade/stage the NAFLD.<h4>Methods</h4>In this cross-sectional study, we measured in 175 males with T2DM total and free testosterone, markers of insulin resistance, and intrahepatic triglyceride content (IHTG) by 1H-MRS. Those with NAFLD on imaging underwent a liver biopsy.<h4>Results</h4>Total testosterone was higher in the group without NAFLD ("No-NAFLD"; n = 48) compared to isolated steatosis (IS; n = 62) or NASH (n = 65) (385 ± 116 vs. 339 ± 143 vs. 335 ± 127 ng/ml, ptrend 0.03). Testosterone was also lower in obese vs. non-obese subjects in both the No-NAFLD and IS groups (p = 0.06 and p = 0.11, respectively), but not in obese vs. non-obese patients with NASH (p = 0.81). IHTG was independently associated with total testosterone (ß = -4.8, p = 0.004). None of the liver histology characteristics were associated with lower testosterone.<h4>Conclusions</h4>NAFLD is linked to lower total testosterone in patients with T2DM, but likely given a common soil of insulin resistance/obesity and not from the severity of liver necroinflammation or fibrosis. Nevertheless, clinicians should consider screening patients with T2DM and NAFLD for hypogonadism.https://doi.org/10.1371/journal.pone.0251449
collection DOAJ
language English
format Article
sources DOAJ
author Kristin Alexandra Dayton
Fernando Bril
Diana Barb
Jinping Lai
Srilaxmi Kalavalapalli
Kenneth Cusi
spellingShingle Kristin Alexandra Dayton
Fernando Bril
Diana Barb
Jinping Lai
Srilaxmi Kalavalapalli
Kenneth Cusi
Severity of non-alcoholic steatohepatitis is not linked to testosterone concentration in patients with type 2 diabetes.
PLoS ONE
author_facet Kristin Alexandra Dayton
Fernando Bril
Diana Barb
Jinping Lai
Srilaxmi Kalavalapalli
Kenneth Cusi
author_sort Kristin Alexandra Dayton
title Severity of non-alcoholic steatohepatitis is not linked to testosterone concentration in patients with type 2 diabetes.
title_short Severity of non-alcoholic steatohepatitis is not linked to testosterone concentration in patients with type 2 diabetes.
title_full Severity of non-alcoholic steatohepatitis is not linked to testosterone concentration in patients with type 2 diabetes.
title_fullStr Severity of non-alcoholic steatohepatitis is not linked to testosterone concentration in patients with type 2 diabetes.
title_full_unstemmed Severity of non-alcoholic steatohepatitis is not linked to testosterone concentration in patients with type 2 diabetes.
title_sort severity of non-alcoholic steatohepatitis is not linked to testosterone concentration in patients with type 2 diabetes.
publisher Public Library of Science (PLoS)
series PLoS ONE
issn 1932-6203
publishDate 2021-01-01
description <h4>Background</h4>Hypogonadism is reported to occur in non-alcoholic fatty liver disease (NAFLD), but earlier studies used low-sensitivity diagnostic techniques (CT, ultrasound), for NAFLD diagnosis. We hypothesized that if hypogonadism was due to NAFLD, and not solely attributable to underlying obesity/diabetes, it would be more severe in the presence of steatohepatitis (NASH). To examine the influence of liver disease on testosterone in males with type 2 diabetes mellitus (T2DM), we used gold-standard liver imaging with MR-spectroscopy (1H-MRS), and performed liver biopsies to grade/stage the NAFLD.<h4>Methods</h4>In this cross-sectional study, we measured in 175 males with T2DM total and free testosterone, markers of insulin resistance, and intrahepatic triglyceride content (IHTG) by 1H-MRS. Those with NAFLD on imaging underwent a liver biopsy.<h4>Results</h4>Total testosterone was higher in the group without NAFLD ("No-NAFLD"; n = 48) compared to isolated steatosis (IS; n = 62) or NASH (n = 65) (385 ± 116 vs. 339 ± 143 vs. 335 ± 127 ng/ml, ptrend 0.03). Testosterone was also lower in obese vs. non-obese subjects in both the No-NAFLD and IS groups (p = 0.06 and p = 0.11, respectively), but not in obese vs. non-obese patients with NASH (p = 0.81). IHTG was independently associated with total testosterone (ß = -4.8, p = 0.004). None of the liver histology characteristics were associated with lower testosterone.<h4>Conclusions</h4>NAFLD is linked to lower total testosterone in patients with T2DM, but likely given a common soil of insulin resistance/obesity and not from the severity of liver necroinflammation or fibrosis. Nevertheless, clinicians should consider screening patients with T2DM and NAFLD for hypogonadism.
url https://doi.org/10.1371/journal.pone.0251449
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