Testosterone replacement does not improve steatotic liver disease for older men
Click Here to Manage Email Alerts
Key takeaways:
- The prevalence of steatotic liver disease was similar among older men who received testosterone therapy for 12 months vs. placebo.
- No change was observed in all scoring systems and liver measurements.
Twelve months of testosterone replacement therapy did not improve metabolic dysfunction-associated steatotic liver disease in a group of older men with hypogonadism, according to a secondary analysis of the T Trials.
“The use of testosterone replacement in older men with [metabolic dysfunction-associated steatotic liver disease (MASLD)] does not improve the disease score of CT liver findings,” Christina Wang, MD, associate director of the Clinical and Translational Science Institute, The Lundquist Institute at Harbor-UCLA Medical Center, told Healio. “Testosterone therapy should be used for hypogonadism and not for [MASLD] in older men.”
Wang and colleagues collected data from 479 men aged 65 years and older with a serum testosterone level of 275 ng/dL or lower who participated in the T Trials. Of those included in the secondary analysis, 246 men were randomly assigned to testosterone gel and 233 were randomly assigned to placebo for 1 year. Medical history was collected at baseline. Total and free testosterone levels, aspartate transaminase, alanine transaminase, total HDL and LDL cholesterol, HbA1c and insulin resistance were assessed during baseline and 12-month laboratory tests. MASLD, which is the new nomenclature replacing nonalcoholic fatty liver disease, was assessed using three measures: lipid accumulation product index, hepatic steatosis index, and nonalcoholic fatty liver disease in metabolic syndrome patients scoring system. MASLD scores were calculated at baseline and 12 months.
Researchers found no difference in the prevalence of MASLD between men in the testosterone group and those receiving placebo with all three scoring systems. Liver Hounsfield unit and liver spleen ratio were also similar between the groups.
Serum total and free testosterone did not differ between men with MASLD and men without MASLD at baseline. At 12 months, men receiving testosterone gel had a greater increase in total testosterone (mean increase, 285.5 ng/dL vs. 1.98 ng/dL; P < .0001) and free testosterone (mean increase, 107.9 pg/dL vs. 0.67 pg/dL; P < .0001) than placebo.
No differences in BMI, waist-to-height ratio, HbA1c or insulin resistance were observed between the testosterone and placebo groups at 12 months. There was also no difference in the change in prevalence of MASLD between the two groups. The percentage of men with absent or borderline MASLD did not change in either group at 12 months. The findings were the same across all MASLD scoring systems.
Wang said the findings were not surprising because a prior secondary analysis of the T Trials also found minimal improvement in the same metabolic biomarkers that she and colleagues assessed.
“We need a larger study in younger men who have [MASLD] and hypogonadism as defined by The Endocrine Society,” Wang said.
For more information:
Christina Wang, MD, can be reached at wang@lundquist.org.
Collapse
Click Here to Manage Email Alerts