Abstract
PurposeRecent studies have suggested the significant relationship between follicle-stimulating hormone (FSH) and non-alcoholic fatty liver disease (NAFLD) in postmenopausal women. However, it is unknown whether FSH impacts the risk of NAFLD in men. This study aimed to investigate the association between serum FSH levels and NAFLD in elderly Chinese men aged 80–98, a particular group with worse outcomes of NAFLD.Patients and methodsA cross-sectional analysis was performed in 444 subjects in a geriatric health center. The highest quartile of serum FSH was used as reference. Hepatic steatosis was defined according to the results of liver ultrasound. Fibrosis-4 (FIB-4) Index > 2.67 was defined as advanced fibrosis.ResultsBased on liver ultrasound, 108 (24.3%) subjects had NAFLD. FSH level were negatively correlated with total testosterone, estradiol, nutritional risk, and the prevalence of high education level (all P < 0.01), and positively correlated with age, luteinizing hormone, alanine aminotransferase and aspartate aminotransferase (all P < 0.05). The correlation between FSH and body mass index or antihypertensive drug usage was marginally significant (P = 0.057; P = 0.066, respectively). The percentage of subjects with NAFLD had a trend to increase following the quartiles of serum FSH (20.0% in quartile 1, 18.2% in quartile 2, 27.3% in quartile 3, and 31.6% in quartile 4). After adjustment for common pathogenic risk factors, nutritional risk, and other sex hormones, serum FSH were progressively associated with odds ratios for NAFLD. The adjusted odds ratios and 95% CIs for quartile 1, quartile 2, and quartile 3, compared with quartile 4 were 0.132 (0.034–0.516), 0.190 (0.052–0.702), and 0.404 (0.139–1.173), respectively. Obesity was not involved in the potential negative role of circulating FSH on the risk of NAFLD in our population. Furthermore, our results revealed no significant association between FSH and advance fibrosis, the OR (95% CI) for advanced fibrosis was 1.018 (0.983–1.054) (P = 0.316) after adjusting for the potential covariates, although a positive correlation of FSH and FIB-4 score was observed (r = 0.325, P = 0.001).ConclusionLow FSH level may decrease the risk of NAFLD in elderly Chinese men. These findings warrant replication in more extensive studies.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is defined as the presence of excessive fat deposition in the liver when the secondary etiologies are excluded
follicle-stimulating hormone (FSH) level were negatively correlated with total testosterone, estradiol, nutritional risk, and the prevalence of high education level, and positively correlated with age, luteinizing hormone, alanine aminotransferase and aspartate aminotransferase
The percentage of subjects with NAFLD had a trend to increase following the quartiles of serum FSH (20.0% in quartile 1, 18.2% in quartile 2, 27.3% in quartile 3, and 31.6% in quartile 4)
Summary
Non-alcoholic fatty liver disease (NAFLD) is defined as the presence of excessive fat deposition in the liver when the secondary etiologies are excluded. It is widely recognized as a major public health problem and is the most rapidly growing contributor to liver mortality and morbidity, according to the 2017 Global Burden of Disease study [1]. NAFLD is observed in 29.62% Asian population regardless of the diagnostic method [2] It elevates liver enzyme levels and causes cirrhosis, but it has a considerable impact on extrahepatic disorders, including diabetes, cardiovascular disease, metabolic syndrome, and other arteriosclerosis diseases [3, 4]. Besides circulating FSH levels, the diurnal rhythm of FSH was reported to associate with NAFLD in a small sample size study (71 subjects) of an elderly population [15]
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