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Cited by 75Hormonal and reproductive studiesLiver Disease Diagnosis and TreatmentAlcohol Consumption and Health Effects

Low testosterone and non-alcoholic fatty liver disease: Evidence for their independent association in men with chronic spinal cord injury

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Barbonetti, Arcangelo, Caterina Vassallo, Maria Rosaria, Cotugno, Michele, Felzani, Giorgio, Francavilla, Sandro, Francavilla, Felice·2016·The Journal of Spinal Cord Medicine
DOI 10.1179/2045772314y.0000000288PMC PMC5102293
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Abstract

OBJECTIVE: Non-alcoholic fatty liver disease (NAFLD) has been claimed as a liver phenotype of metabolic syndrome, which in turn is associated with male hypogonadism. We assessed whether an independent association between NAFLD and androgen deficiency could be revealed in men with chronic spinal cord injury (SCI), who exhibit a high prevalence of biochemical androgen deficiency and a combination of risk factors for metabolic syndrome. DESIGN: Fifty-five consecutive men with chronic SCI admitted to a rehabilitation program underwent clinical/biochemical evaluations and liver ultrasonography. RESULTS: NAFLD was diagnosed in 27 patients (49.1%). Men with NAFLD were older and exhibited significantly higher body mass index, Homeostatic model assessment of insulin resistance, triglycerides and gamma-glutamyl transpeptidase values, lower total and free testosterone levels and they were engaged in a significantly poorer weekly leisure time physical activity (LTPA). At the multiple logistic regression analysis, only total and free testosterone levels exhibited a significant independent association with NAFLD. The risk of having NAFLD increased indeed of 1% for each decrement of 1 ng/dL of total testosterone and of 3% for each decrement of 1 pg/mL of free testosterone, after adjustment for confounders. In men with total testosterone < 300 ng/dL (36.4%) the prevalence of NAFLD reached 85%: they had a risk of having NAFLD significantly higher (∼12-fold) than those with total testosterone ≥ 300 ng/dL, after adjustment for confounders. CONCLUSION: The evidence of an independent association between NAFLD and low testosterone is strongly reinforced by its demonstration in men with chronic SCI, in spite of the many confounders peculiar to this population.

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  • Regarding calculated free T, literature remains undecided describing either an inverse, positive or no association with NAFLD.

    “Regarding calculated free T, literature remains undecided describing either an inverse, positive or no association with NAFLD [140–143].”

    From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [142]

    The Methods section (page not supplied) says free testosterone was calculated from total testosterone, SHBG, and albumin. Table 2 and the Discussion report an inverse association with NAFLD in men with chronic spinal cord injury. This paper supports the inverse-association part of the citing sentence, but does not document positive or absent associations or establish that the literature is undecided. (LLM, conf=0.86)

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Authors
Barbonetti, A., Caterina Vassallo, M. R., Cotugno, M., Felzani, G., Francavilla, S., & Francavilla, F.
Affiliations
  • University of L'Aquila (IT)
  • Andrology Unit, Department of Life, Health and Environment Sciences, University of L'Aquila, L'Aquila, Italy
  • Spinal Unit, San Raffaele Sulmona Institute, Sulmona, Italy
Corresponding author
Barbonetti, Arcangelo
ORCID
Venue
The Journal of Spinal Cord Medicine
Publisher
Informa UK Limited
Published
2016-02-25
Volume
39
Issue
4
Pages
443-449
ISSN
  • 1079-0268 (ISSN-L)
  • 2045-7723
DOI
10.1179/2045772314y.0000000288
PMC
PMC5102293
OpenAlex
W2066719933
Cited by
75
References
8
Citations by year
2026: 4 · 2025: 6 · 2024: 7 · 2023: 7 · 2022: 9 · 2021: 10 · 2020: 9 · 2019: 7 · 2018: 6 · 2017: 6 · 2016: 2 · 2015: 2
FWCI
4.64
Type
journal article
Language
en
Open access
Locations
  • Journal of Spinal Cord Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion)
Funders
Ministero dell'Università e della Ricerca
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
non-alcoholic fatty liver disease, androgen deficiency, male hypogonadism, chronic spinal cord injury, metabolic syndrome, free testosterone, insulin resistance, physical activity, liver ultrasound
MeSH terms
Adult, Humans, Male, Middle Aged, Spinal Cord Injuries, Testosterone, Non-alcoholic Fatty Liver Disease

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