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Association of non-alcoholic fatty liver disease with total testosterone in non-overweight/obese men with type 2 diabetes mellitus

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Abstract

Purpose

Non-alcoholic fatty liver disease (NAFLD) is considered as both a vital risk factor and a consequence of type 2 diabetes mellitus (T2DM). Low total testosterone (TT) is common in men with T2DM, contributing to increased risks of metabolic diseases. This study aimed to investigate the association between TT levels and the prevalence of NAFLD in men with T2DM.

Methods

In this cross-sectional study, 1005 men with T2DM were enrolled in National Metabolic Management Center (MMC) of First Affiliated Hospital of Wenzhou Medical University between January 2017 and August 2021. NAFLD was diagnosed using ultrasound as described by the Chinese Liver Disease Association. Overweight/obesity was defined as body mass index (BMI) ≥ 25 kg/m2 according to WHO BMI classifications.

Results

Individuals without NAFLD had higher serum TT levels than those with NAFLD. After adjustments for potential confounding factors, the top tertile was significantly associated with lower prevalence of NAFLD compared with the bottom tertile of TT level [odds ratio (OR) 0.303, 95% confidence interval (CI) 0.281–0.713; P < 0.001]. The association between TT with NAFLD in individuals with normal weight (OR 0.175, 95% CI 0.098–0.315; P < 0.001) was stronger than in individuals with overweight/obesity (OR 0.509, 95% CI 0.267–0.971; P = 0.040). There was a significant interaction of TT with overweight/obesity (P for interaction = 0.018 for NAFLD).

Conclusion

Higher serum TT was significantly associated with a lower prevalence of NAFLD in men with T2DM. We found that the relationship of TT and NAFLD was stronger in individuals with non-overweight/obesity.

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Acknowledgements

We sincerely thank the individuals involved in the present study. We also thank the support of all the colleagues in the Department of Endocrine and Metabolic Diseases at the First Affiliated Hospital of Wenzhou Medical University.

Funding

This work was funded by the Natural Science Foundation of Zhejiang Province (Project No. LY20H070003) and the National Natural Science Foundation of China (81900737).

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Author notes

  1. L.J. Yang and J.Z. Zhou have contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrine and Metabolic Diseases, The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, 325000, Zhejiang Province, China

    L. J. Yang, J. Z. Zhou, Y. F. Zheng, X. Hu, Z. Y. He, L. J. Du, X. Gu, X. Y. Huang, J. Li, Y. Q. Li, L. Y. Pan, X. X. Zhang & X. J. Gu

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  1. L. J. Yang
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Contributions

All authors made a significant contribution to the work reported. XJG designed the experiments. LJY, JZZ, YFZ, ZYH, LJD, XG, XYH, JL, YQL, LYP, and XXZ performed the experiments. JZZ, LJY, and XJG analyzed and interpreted the data. LJY, JZZ, and XH wrote the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to X. J. Gu.

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The authors declare that they have no conflicts of interest.

Ethical approval

This study was approved by the Institutional Review Board of First Affiliated Hospital of Wenzhou Medical University (Project No. KY2021-173).

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Written consent was obtained from all participants.

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Yang, L.J., Zhou, J.Z., Zheng, Y.F. et al. Association of non-alcoholic fatty liver disease with total testosterone in non-overweight/obese men with type 2 diabetes mellitus. J Endocrinol Invest 46, 1565–1572 (2023). https://doi.org/10.1007/s40618-023-02006-6

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