Background: A positive relationship between testosterone level and nonalcoholic fatty liver disease (NAFLD) in women has been reported, but findings concerning the association are conflicting and inconclusive. Materials and Methods: We examined the association between testosterone level and the risk of NAFLD after stratification by menopausal status in 613 women (223 premenopausal women aged 21-52 years and 390 postmenopausal women aged 46-75 years). A diagnosis of fatty liver was based on abdominal ultrasonography. The odds ratios (ORs) and 95% confidence intervals (95% CIs) for NAFLD with 1 nmol/L increment in the log testosterone concentration were calculated after adjusting for confounding variables using multiple logistic regression analysis. Results: The prevalence of NAFLD was 19.2% among premenopausal women and 33.3% among postmenopausal women. After adjusting for age, regular exercise, type 2 diabetes, body mass index, mean arterial pressure, fasting plasma glucose, triglyceride, and high-density lipoprotein cholesterol, and testosterone levels, the OR (95% CI) for NAFLD was 2.79 (1.11-7.08) with 1 nmol/L increment of the log testosterone concentration in premenopausal women. However, these positive associations were not found in postmenopausal women after adjusting for the same covariables. Conclusion: Serum testosterone level was positively associated with NAFLD in premenopausal women but not in postmenopausal women. Our findings suggest that higher androgenic activity may be at least partly involved in the pathogenesis of NAFLD, particularly in premenopausal women.
Keywords: insulin resistance; menopause; nonalcoholic fatty liver disease; testosterone.