Endocrine Abstracts

Background: Nonalcoholic fatty liver disease (NAFLD) is the most common cause of liver diseases, and the presence of type 2 diabetes mellitus (T2DM) increases its incidence up to 90%. To date, the effect of androgen deficiency in men with T2DM on the development of NAFLD has not been studied.

Aim: To assess the effect of the endogenous testosterone (T) level on the incidence of NAFLD in men with T2DM.

Materials and methods: The study included 50 men with T2DM (mean age 53.6±5.9 years) who were divided into 2 groups: the 1^st one included 20 patients with T level ≥12.1 nmol/l, the 2^nd - 30 men with T level <12.1 nmol/l. Patients underwent clinical examinations, such as: assess of anthropometric data (weight, BMI, waist circumference (WC), hip circumference (HC)), evaluation of parameters of carbohydrate and lipid metabolism, liver transaminases, total T level, immunoreactive insulin (IRI) and leptin concentrations. Also, all patients underwent magnetic resonance imaging (MRI) of the liver by the Dickson method with a double gradient echo into the phase and antiphase to quantify the liver fat fraction (FF), which allowed to determine the presence and severity of NAFLD. For statistical data processing, the STATISTICA software package (StatSoft 10) was used. The statistical analysis was carried out using the Mann-Whitney U test, a critical significance level was taken to be P <0.05. For statistical data processing, the STATISTICA software package (StatSoft 10) was used.

Results: The severity of obesity according to BMI, WC, HC was significantly higher in patients of the 2^nd group. This was accompanied by a significantly higher level of IRI by 30% (P=0.049) and twice higher leptin level (P=0.0008) in patients with androgen deficiency, compared to the control group. In addition, in the 2^nd group, the level of ALT was significantly (P=0.034) higher by 25% compared to patients of group 1. In men with a low level of endogenous T, the liver fat fraction was significantly (P=0.0002) 2.5-fold higher than in men without androgen deficiency (10.96 (7.78; 14.44) vs 4.2 (2.25; 5.86)%). These findings demonstrate the higher severity of NAFLD in men with late onset hypogonadism compared to patients not having T deficiency.

Conclusion: T deficiency in men with T2DM promotes the development and aggravation of the already existing NAFLD.

Keywords: Testosterone, liver, diabetes mellitus