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

The Journal of Spinal Cord Medicine, 2016 · DOI: 10.1179/2045772314Y.0000000288 · Published: January 1, 2016

Spinal Cord Injury Endocrinology Gastroenterology

Simple Explanation

This study investigates the link between low testosterone and non-alcoholic fatty liver disease (NAFLD) in men with chronic spinal cord injury (SCI). NAFLD is fat buildup in the liver not caused by excessive alcohol. Men with SCI often have both low testosterone and risk factors for metabolic syndrome, making them a good group to study this relationship. The researchers wanted to see if low testosterone and NAFLD are independently related, even with other health issues present. The study found that lower testosterone levels were indeed independently associated with NAFLD in these men, suggesting a direct link between the two.

Study Duration

Not specified

Participants

55 men with chronic spinal cord injury

Evidence Level

Not specified

Key Findings

1
NAFLD was diagnosed in 49.1% of the men with chronic SCI.
2
Lower total and free testosterone levels were independently associated with NAFLD, even after considering other factors like age, BMI, and insulin resistance.
3
Men with low testosterone (<300 ng/dL) had a significantly higher risk (12-fold) of having NAFLD compared to those with normal testosterone levels.

Research Summary

This study examined the relationship between NAFLD and low testosterone in men with chronic SCI, a population with a high prevalence of both conditions and metabolic risk factors. The results showed a significant independent association between low total and free testosterone levels and NAFLD, suggesting a direct link between androgen deficiency and liver fat deposition. The findings reinforce the idea that low testosterone and NAFLD are related, even when considering other health issues common in men with SCI.

Practical Implications

Clinical Screening

Men with chronic SCI should be screened for both NAFLD and low testosterone levels, especially those with metabolic risk factors.

Therapeutic interventions

Further research is needed to determine if testosterone replacement therapy can improve NAFLD in men with chronic SCI and low testosterone.

Further Research

Additional studies are needed to confirm the prevalence of NAFLD in SCI patients and the mechanisms underlying the association with low testosterone.

Study Limitations

1
The study used ultrasonography to diagnose NAFLD, which is less accurate than liver biopsy.
2
The study's cross-sectional design limits the ability to determine cause-and-effect relationships.
3
The findings are based on a relatively small sample size of 55 men with chronic SCI.

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