Metabolic dysfunction-associated fatty liver disease is an early predictor for testosterone deficiency in aging men without metabolic syndrome

Chia-Chu Liu; Shu-Pin Huang; Yung-Chin Lee; Cheng-Hsueh Lee; Tsung-Yi Huang; Jiun-Hung Geng; Che-Wei Chang; Chung-Yu Lin; Yung-Shun Juan; Wen-Jeng Wu; Tusty-Jiuan Hsieh

doi:10.3389/fendo.2023.1252774

Metabolic dysfunction-associated fatty liver disease is an early predictor for testosterone deficiency in aging men without metabolic syndrome

Front Endocrinol (Lausanne). 2023 Oct 3:14:1252774. doi: 10.3389/fendo.2023.1252774. eCollection 2023.

Authors

Chia-Chu Liu^{1

2

3

4}, Shu-Pin Huang^{1

2}, Yung-Chin Lee^{1

2

5}, Cheng-Hsueh Lee¹, Tsung-Yi Huang¹, Jiun-Hung Geng^{2

5}, Che-Wei Chang^{1

3}, Chung-Yu Lin¹, Yung-Shun Juan^{1

2}, Wen-Jeng Wu^{1

2}, Tusty-Jiuan Hsieh^{4

6}

Affiliations

¹ Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.
² Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
³ Department of Urology, Pingtung Hospital, Ministry of Health and Welfare, Pingtung City, Taiwan.
⁴ Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
⁵ Department of Urology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung City, Taiwan.
⁶ Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.

Abstract

Background and aims: Metabolic dysfunction-associated fatty liver disease (MAFLD) has emerged as a valuable marker for identifying individuals at increased risk of metabolic dysfunction, liver-related complications, and cardiovascular disease. However, the association between MAFLD and testosterone deficiency (TD) in aging men remains poorly understood. This study aimed to investigate the association between MAFLD and the risk of TD in aging Taiwanese men, with a specific focus on those without metabolic syndrome (MetS).

Methods: A free health screening program was conducted for Taiwanese men aged over 40 years in Kaohsiung, Taiwan. Participants underwent physical examinations, completed questionnaires regarding demographics, medical history, and clinical symptoms of TD, and provided 20-mL whole blood samples for biochemical, adipocytokine, and hormonal evaluations. Fatty liver index was used to evaluate the risk of fatty liver. Diagnostic criteria for MAFLD included fatty liver along with overweight/obesity, type 2 diabetes, or evidence of metabolic dysregulation.

Results: A total of 631 men (mean age: 54.4 ± 8.4 years) were enrolled. The prevalence rates of TD and MetS were significantly higher in men with MAFLD compared to those without (both p < 0.001). Additionally, the presence of MAFLD showed a significant correlation with adipocytokines associated with insulin resistance, such as adiponectin, leptin, and retinol-binding protein-4 (RBP-4) levels (all p < 0.001). Among men without MetS, those with MAFLD had a 3.89- and 4.74-fold higher risk of total testosterone < 300 ng/dL and TD, respectively, after adjusting for potential covariates.

Conclusion: MAFLD is associated with an elevated risk of TD in aging Taiwanese men, particularly in the absence of MetS. This finding suggests that MAFLD could serve as an early predictor of TD, facilitating the identification of high-risk individuals and enabling timely interventions. Further research is needed to validate these findings and explore the underlying mechanisms linking MAFLD, TD, and MetS in diverse populations.

Keywords: aging men; insulin resistance; metabolic dysfunction-associated fatty liver disease; metabolic syndrome; testosterone deficiency.

MeSH terms

Adipokines
Adult
Aging
Diabetes Mellitus, Type 2*
Humans
Insulin Resistance*
Male
Metabolic Syndrome* / complications
Metabolic Syndrome* / diagnosis
Metabolic Syndrome* / epidemiology
Middle Aged
Non-alcoholic Fatty Liver Disease*

Substances

Adipokines

Grants and funding

This study was supported by grants from the Ministry of Science and Technology, Taiwan (MOST 109-2314-B-037-104-MY3), National Science and Technology Council, Taiwan (NSTC 112-2314-B-037-071), Ministry of Health and Welfare, Taiwan (11239), Kaohsiung Medical University, Kaohsiung, Taiwan (NHRI-KMU-112-I001), and Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (KMUH110-0R56 and KMUH111-1R57). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.