脂肪肝指數在無代謝症候群的老化男性與睪固酮低下風險相關

劉家駒^1-4, 黃書彬^1,2, 謝翠娟^4-5, 李政學¹, 鄭凱鴻⁶, 黃琮懿¹, 耿俊閎⁷,

李經家^1,2, 吳文正^1,2, 李永進^1,2,7

高雄醫學大學附設醫院 泌尿科¹  高雄醫學大學 醫學院 醫學系 泌尿學科²

衛生福利部 屏東醫院 泌尿科³  高雄醫學大學 環境醫學研究中心⁴

高雄學大學 醫學院 醫學研究所⁵  義大醫院 內科部 心臟內科⁶

高雄市立小港醫院(委託財團法人高雄醫學大學經營)  泌尿科⁷

Fatty liver index is associated with the risk of testosterone deficiency in aging men without metabolic syndrome

Chia-Chu Liu^1-4, Shu-Pin Huang^1,2, Tusty-Jiuan Hsieh^4,5, Cheng-Hsueh Lee¹, Kai-Hung Cheng⁶, Tsung-Yi Huang¹, Jiun-Hung Geng⁷, Ching-Chia Li^1,2, Wen-Jeng Wu^1,2, Yung-Chin Lee^1,2,7

¹Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University

²Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University

³Department of Urology, Pingtung Hospital, Ministry of Health and Welfare

⁴Research Center for Environmental Medicine, Kaohsiung Medical University

⁵Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University

⁶Division of Cardiology, Department of Internal Medicine, E-Da Hospital

⁷Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital

Purpose:

Nonalcoholic fatty liver disease (NAFLD) is suggested to be a precursor of metabolic syndrome (MetS) and could influence the risk of testosterone deficiency (TD). Fatty liver index (FLI) is a simple and useful screening tool for NAFLD. We determined the association between the risk of NAFLD assessed by FLI and TD in aging Taiwanese men, especially those without MetS.

Materials and Methods:

A free health screening program was conducted for men (age: >40 years) in a medical center in Kaohsiung, Taiwan. All participants underwent a physical examination; answered a questionnaire assessing demographics, medical history and clinical symptoms of TD; and provided 20-mL whole blood samples for biochemical, adipocytokine and hormonal evaluations. The risk of NAFLD was evaluated using FLI. The presence of NAFLD was ruled out if FLI value was <25 and ruled in if FLI value was ≥35.

Results:

552 men (mean age: 54.7 ± 7.7 years) was enrolled. The prevalence rates of TD and MetS were significantly higher among men with NAFLD than those without NAFLD (both p <0.001). FLI was significantly correlated with total testosterone (TT) and adipocytokines associated with insulin resistance, such as adiponectin, leptin and retinol-binding protein-4 (RBP-4) levels, respectively (all p<0.001). Among men without MetS, those at risk of and with NAFLD had a 3.82- and 8.50-times higher risk of TD, respectively, than those without NAFLD after adjusting for potential covariates

Conclusion:

The FLI is associated with the risk of TD in aging Taiwanese men, especially in those without MetS. Our findings also suggest that insulin resistance may be an important link among the inter-relationships of NAFLD, MetS, and TD. Further population-based studies with larger sample sizes of different ethnicities are warranted to confirm these preliminary results.