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Testosterone is Associated With Nonalcoholic Steatohepatitis and Fibrosis in Premenopausal Women With NAFLD.

Publication ,  Journal Article
Sarkar, MA; Suzuki, A; Abdelmalek, MF; Yates, KP; Wilson, LA; Bass, NM; Gill, R; Cedars, M; Terrault, N; NASH Clinical Research Network,
Published in: Clin Gastroenterol Hepatol
June 2021

BACKGROUND & AIMS: Higher testosterone contributes to imaging-confirmed nonalcoholic fatty liver disease (NAFLD) in women, but whether testosterone influences their disease severity is unknown. METHODS: The association of free testosterone (free T) with nonalcoholic steatohepatitis (NASH) was determined in pre-menopausal women with biopsy-confirmed NAFLD (n = 207). Interaction testing was performed for age and free T given decline in testosterone with age, and association of aging with NASH. Regression models adjusted for abdominal adiposity, diabetes, and dyslipidemia. RESULTS: Median age was 35 yrs (interquartile range, 29-41); 73% were white, 25% Hispanic; 32% had diabetes, 93% abdominal adiposity, and 95% dyslipidemia. 69% had NASH, 67% any fibrosis, and 15% advanced fibrosis. Higher free T levels were associated with NAFLD severity in younger women (interaction P value <.02). In the youngest age quartile, free T was independently associated with NASH (odds ratio [OR], 2.3; 95% CI, 1.2-4.4), NASH fibrosis (OR, 2.1; 95% CI, 1.1-3.8), and higher fibrosis stage (OR, 1.9; 95% CI, 1.1-3.4), P value .02. In these women, the proportion with NASH steadily rose from 27% to 88%, and with NASH fibrosis rose from 27% to 81%, with higher free T quartiles (P < .01). Free T was additionally associated with abdominal adiposity among all pre-menopausal women (OR, 2.2; 95% CI, 1.2-4.1: P = .02). CONCLUSIONS: In young women with NAFLD, higher testosterone levels conferred a 2-fold higher risk of NASH and NASH fibrosis, and increased risk of abdominal adiposity, supporting a potential mechanistic link of abdominal fat on testosterone-associated liver injury. Testosterone may represent an early risk factor for NASH progression in young women, prior to their onset of more dominant, age-related metabolic risk factors.

Duke Scholars

Published In

Clin Gastroenterol Hepatol

DOI

EISSN

1542-7714

Publication Date

June 2021

Volume

19

Issue

6

Start / End Page

1267 / 1274.e1

Location

United States

Related Subject Headings

  • Testosterone
  • Obesity, Abdominal
  • Non-alcoholic Fatty Liver Disease
  • Liver Cirrhosis
  • Liver
  • Humans
  • Gastroenterology & Hepatology
  • Fibrosis
  • Female
  • Adult
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Sarkar, M. A., Suzuki, A., Abdelmalek, M. F., Yates, K. P., Wilson, L. A., Bass, N. M., … NASH Clinical Research Network, . (2021). Testosterone is Associated With Nonalcoholic Steatohepatitis and Fibrosis in Premenopausal Women With NAFLD. Clin Gastroenterol Hepatol, 19(6), 1267-1274.e1. https://doi.org/10.1016/j.cgh.2020.09.045
Sarkar, Monika A., Ayako Suzuki, Manal F. Abdelmalek, Katherine P. Yates, Laura A. Wilson, Nathan M. Bass, Ryan Gill, Marcelle Cedars, Norah Terrault, and Norah NASH Clinical Research Network. “Testosterone is Associated With Nonalcoholic Steatohepatitis and Fibrosis in Premenopausal Women With NAFLD.Clin Gastroenterol Hepatol 19, no. 6 (June 2021): 1267-1274.e1. https://doi.org/10.1016/j.cgh.2020.09.045.
Sarkar MA, Suzuki A, Abdelmalek MF, Yates KP, Wilson LA, Bass NM, et al. Testosterone is Associated With Nonalcoholic Steatohepatitis and Fibrosis in Premenopausal Women With NAFLD. Clin Gastroenterol Hepatol. 2021 Jun;19(6):1267-1274.e1.
Sarkar, Monika A., et al. “Testosterone is Associated With Nonalcoholic Steatohepatitis and Fibrosis in Premenopausal Women With NAFLD.Clin Gastroenterol Hepatol, vol. 19, no. 6, June 2021, pp. 1267-1274.e1. Pubmed, doi:10.1016/j.cgh.2020.09.045.
Sarkar MA, Suzuki A, Abdelmalek MF, Yates KP, Wilson LA, Bass NM, Gill R, Cedars M, Terrault N, NASH Clinical Research Network. Testosterone is Associated With Nonalcoholic Steatohepatitis and Fibrosis in Premenopausal Women With NAFLD. Clin Gastroenterol Hepatol. 2021 Jun;19(6):1267-1274.e1.
Journal cover image

Published In

Clin Gastroenterol Hepatol

DOI

EISSN

1542-7714

Publication Date

June 2021

Volume

19

Issue

6

Start / End Page

1267 / 1274.e1

Location

United States

Related Subject Headings

  • Testosterone
  • Obesity, Abdominal
  • Non-alcoholic Fatty Liver Disease
  • Liver Cirrhosis
  • Liver
  • Humans
  • Gastroenterology & Hepatology
  • Fibrosis
  • Female
  • Adult