Association between low testosterone levels and sarcopenia in cirrhosis: A cross-sectional study
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INTRODUCTION AND AIM: Sarcopenia is an independent predictor of mortality in cirrhosis. Hypogonadism is common in cirrhosis and has been associated with sarcopenia in non-cirrhotic chronic liver disease populations. The aim of this study is to investigate if sarcopenia is associated with low testosterone levels in patients with cirrhosis. MATERIAL AND METHODS: This is a retrospective analysis of prospectively collected data of 211 cirrhotic patients undergoing evaluation for liver transplantation. Sarcopenia was defined by computed tomography (CT) scan using specific cutoffs of the 3rd lumbar vertebra skeletal muscle index (L3 SMI). Morning testosterone levels were obtained in all patients. RESULTS: Of the 211 patients, sarcopenia was noted in 94 (45%). Testosterone levels were lower in sarcopenic patients (10.7 ± 1.1 vs. 13.7 ± 1.4 nmol/L, p = 0.03) and hypotestosteronemia was more frequent in them too (34 vs. 16%, p = 0.004). In males, those with sarcopenia had lower testosterone levels (14.6 ± 1.4 vs. 21.9 ± 1.8, p = 0.002), and the corresponding frequency of hypotestosteronemia (42 vs. 19%, p = 0.006) was also higher. There were no significant differences in female patients. There was a weak correlation between L3 SMI and testosterone levels (r 0.37, p < 0.001). On multivariable regression analysis including sex, body mass index (BMI), hypotestosteronemia, MELD and etiology of cirrhosis, only hypotestosteronemia (RR 2.76, p = 0.005) and BMI (RR 0.88, p < 0.001) were independently associated with sarcopenia. CONCLUSION: Low testosterone levels are associated with sarcopenia in male cirrhotic patients. The potential therapeutic effect of testosterone to reverse sarcopenia in these patients warrants evaluation in future trials.
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Age-related decreases in sex steroid hormones in both men and women are implicated as critical factors in the development of sarcopenia.
“Along with mitochondrial alteration, age-related decreases in sex steroid hormones in both men and women have been implicated as critical factors in the development of sarcopenia (21, 22).”
From From mitochondria to sarcopenia: role of 17β-estradiol and testosterone (2023) · cites this paper as [22]
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References 33 · Cited by 70
- Authors
- Moctezuma-Velázquez, C., Low, G., Mourtzakis, M., Ma, M., Burak, K. W., Tandon, P., & Montano-Loza, A. J.
- Affiliations
- Alberta Hospital Edmonton (CA)
- University of Waterloo (CA)
- University of Calgary (CA)
- Venue
- Annals of Hepatology
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 17
- Issue
- 4
- Pages
- 615-623
- ISSN
- 1665-2681 (ISSN-L)
- OpenAlex
- W2807904546
- Cited by
- 70
- References
- 33
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 8 · 2023: 12 · 2022: 7 · 2021: 7 · 2020: 8 · 2019: 8
- FWCI
- 3.94
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Annals of Hepatology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Keywords
- sarcopenia, liver cirrhosis, hypogonadism, androgen deficiency, liver transplant candidates, skeletal muscle index, body mass index, sex differences, chronic liver disease
- MeSH terms
- Body Composition, Cross-Sectional Studies, Female, Humans, Hypogonadism, Liver Cirrhosis, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Factors, Testosterone, Tomography, X-Ray Computed, Biomarkers, Muscle, Skeletal, Sarcopenia
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