This article is more than 5 years old. Information may no longer be current.
Androgen levels may influence steatosis to steatohepatitis progression
Click Here to Manage Email Alerts
Insulin resistance and an increase in liver fat were found to be associated with hyperandrogenism in adolescent girls as it is in adult women, whereas higher androgen levels were associated with increased alanine transaminase, which may suggest more advanced disease, according to study findings presented at the Pediatric Academic Societies and Asian Society for Pediatric Research joint meeting in Vancouver, British Columbia.
Jennifer L. Rehm, MD, of the University of Wisconsin School of Medicine and Public Health, and colleagues showed a “strong correlation” of sex hormone-binding globulin with insulin resistance and hepatic fat in normal-weight and overweight patients, but an elevation in higher alanine transaminase (ALT) and hepatic fat only in overweight patients. These findings suggested that hepatic insulin resistance develops before obesity, but that androgens are not implicated in development of nonalcoholic fatty liver disease in pre-obese adolescents.
Jennifer L. Rehm
“When we looked at the normal-weight girls, we were trying to get a sense of chicken and egg, and we saw some weak correlation with androgens and insulin resistance. We didn’t really see correlation with amount of fat in the liver,” Rehm told Endocrine Today. “Once the girls were overweight, we again saw stronger correlations with the androgens and insulin resistance in that group, and then we begin to see correlations with the amount of androgen and the amount of hepatic fat, as well as the degree of elevation in the liver enzymes.”
In an interview, Rehm said this research was aimed at determining whether higher androgen levels influence severity and progression of steatohepatitis.
Researchers divided the 22 girls who met the criteria for hepatic steatosis (fat fraction >5.5%) into high and low androgen groups, she said. Those in the high androgen group had significantly higher mean liver fat fraction and significantly higher ALT vs. those in the low androgen group.
“That suggests to us that maybe androgens are playing a role in progression of disease,” Rehm said. “Maybe looking at the link between androgens and progression will help prevent these irreversible changes from developing.”
She said these findings may contribute to the discussion of treating insulin resistance in adolescents with metformin or hyperandrogenemia with oral contraceptives if the population is at higher risk for steatohepatitis.
Rehm cautioned that ALT is a weak marker for hepatocellular changes, and she said she believes that it is important to use ultrasound or MRI in future studies. — by Katrina Altersitz
For more information:
Rehm JL. #2865.3. Presented at: the Pediatric Academic Societies and Asian Society for Pediatric Research joint meeting; May 3-6, 2014; Vancouver, British Columbia.
Disclosure: This research was supported by Endocrine Fellows Foundation, Genentech Center for Clinical Research, Pediatric Endocrine Society, National Institutes of Health grants, and Wisconsin Alumni Research Foundation Accelerator Program.