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Correlation Between Sex Hormones and Non-alcoholic Fatty Liver Disease Before and After Laparoscopic Sleeve Gastrectomy

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Abstract

Objectives

To investigate the cross-sectional and longitudinal correlation between sex hormones and non-alcoholic fatty liver disease (NAFLD) in patients with obesity before and after laparoscopic sleeve gastrectomy (LSG).

Methods

A total of 360 patients with obesity aged 16–48 years (170 men and 190 women) were enrolled between May 2017 and March 2021. Among them, 132 patients (55 men and 77 women) who underwent LSG had follow-up data. Anthropometric parameters, metabolic variables, and sex hormones were measured. NAFLD was assessed by FibroScan with controlled attenuation parameter (CAP) and liver stiffness measurement (LSM).

Results

In the preoperative cohort, levels of CAP and LSM were significantly higher in men than women. Lower total testosterone (TT) was associated with higher CAP and LSM in men, whereas higher TT was associated with higher CAP in women. In the postoperative cohort, TT levels and NAFLD were significantly modified after LSG in both genders. Changes in TT levels at 3 months after surgery were negatively correlated with changes in CAP levels in men, and changes in TT levels at 6 months after surgery were positively correlated with changes in CAP levels in women. After adjusting possible confounders, the changes in TT levels were independently correlated with CAP variation in both genders.

Conclusions

LSG significantly modified TT levels and NAFLD in both genders. The correlation between TT levels and NAFLD at baseline as well as the changes after surgery suggested TT levels play an important role in the development and regression of NAFLD in both genders.

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Funding

This study was supported by the National Key R&D Program of China (2018YFC1314100), Clinical Research Plan of SHDC (No. SHDC2020CR1017B), the Natural Science Foundation of China (81970677), and the Shanghai Committee of Science and Technology, China (18411951803, 17AZ1910603).

Author information

Author notes

  1. Diliqingna Dilimulati, Meili Cai, and Ziwei Lin are contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, 301 Middle Yanchang Road, Shanghai, 200072, China

    Diliqingna Dilimulati, Meili Cai, Ziwei Lin, Yuqin Zhang, Lei Du, Donglei Zhou, Jiangfan Zhu, Lili Su, Yu Wang, Manna Zhang & Shen Qu

  2. National Metabolic Management Center, Shanghai Tenth People’s Hospital, Shanghai, 200072, China

    Ziwei Lin, Manna Zhang & Shen Qu

  3. Department of Metabolism Surgery, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai, 200072, China

    Lei Du, Donglei Zhou, Jiangfan Zhu, Lili Su & Yu Wang

Authors
  1. Diliqingna Dilimulati
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  2. Meili Cai
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  10. Manna Zhang
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  11. Shen Qu
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Contributions

Conceived and designed of the study: SQ and MZ. Acquisition, statistical analysis, or interpretation of the data: DD, MC, and ZL. Evaluation and implementation of LSG surgery: LD, DZ, and JZ.

Follow-up of surgical patients: LS and YW. Checking and interpretation of the data, drafting of the manuscript, and approved the submitted version of the manuscript: all authors.

Corresponding authors

Correspondence to Manna Zhang or Shen Qu.

Ethics declarations

Ethical Approval

The study was in line with the principles of the Declaration of Helsinki and the study protocol was approved by the Ethical Committee of Shanghai Tenth People’s Hospital.

Informed Consent

All participants of this study signed written informed consent.

Conflict of Interest

The authors declare no competing interests.

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Key Points

• The TT levels and NAFLD were closely interrelated in patients with obesity in a sexually dimorphic way.

• The TT levels and NAFLD were significantly modified after LSG in both genders.

• The variation of TT levels and improvement of NAFLD after LSG were closely correlated in both genders.

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Dilimulati, D., Cai, M., Lin, Z. et al. Correlation Between Sex Hormones and Non-alcoholic Fatty Liver Disease Before and After Laparoscopic Sleeve Gastrectomy. OBES SURG 31, 4901–4910 (2021). https://doi.org/10.1007/s11695-021-05663-9

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  • DOI: https://doi.org/10.1007/s11695-021-05663-9

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