Young women with hyperandrogenism have high risk of metabolic co-morbidities, including increased risk of nonalcoholic fatty liver disease (NAFLD).
Whether testosterone is associated with NAFLD independent of metabolic co-factors is unclear.
Additionally, whether testosterone confers increased risk of NAFLD in women without hyperandrogenism is unknown.
Among women in the prospective population-based multicenter Coronary Artery Risk Development in Young Adults (CARDIA) study, Dr Monika Sarkar and colleagues from California, USA assessed whether free testosterone levels measured at Year 2 (1987–1988) were associated with prevalent NAFLD at Year 25 (2010–2011).
NAFLD was defined using noncontrast abdominal CT scan with liver attenuation ≤40 Hounsfield units after excluding other causes of hepatic fat.
|Visceral adipose tissue volume partially mediated the association of free testosterone with NAFLD|
|American Journal of Gastroenterology|
The researchers found that increasing quintiles of free testosterone were associated with prevalent NAFLD at Year 25, independent of insulin resistance, body mass index, waist circumference, and serum lipids.
Importantly, the team noted that the association persisted among 955 women without androgen excess.
The research team observed that visceral adipose tissue volume partially mediated the association of free testosterone with NAFLD.
Dr Sarkar's team concludes, "Increasing free testosterone is associated with prevalent NAFLD in middle age, even in women without androgen excess."
"Visceral adiposity appears to play an important role in the relationship between testosterone and NAFLD in women."
"Testosterone may provide a potential novel target for NAFLD therapeutics, and future studies in pre-menopausal women should consider the importance of testosterone as a risk factor for NAFLD."