ArticleThe Journal of clinical endocrinology and metabolism2020
Sex Hormone Relations to Histologic Severity of Pediatric Nonalcoholic Fatty Liver Disease.
Article in The Journal of clinical endocrinology and metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Non-alcoholic fatty liver disease across endocrinopathies: Interaction with sex hormones.Frontiers in endocrinology · 2022Pooled it
- Updates on paediatric MASLD: insights from an endocrine lens.Diabetologia · 2026Review
- Sex-specific associations between pubertal development and MASLD in children: evidence from the PROC study.Pediatric research · 2026Article
- EDL6D, a bioactive peptide phenocopying SHBG-associated metabolic effects: a new preclinical lead compound for treating the metabolic dysfunction-associated fatty liver disease.Journal of translational medicine · 2026Article
- Network Pharmacology-Based Analysis Reveals the Mechanisms of the Tibetan Medicinal PlantCurrent issues in molecular biology · 2026Article
- Estradiol negatively associates with metabolic dysfunction-associated steatotic liver disease in children.Frontiers in endocrinology · 2026Article
- Hepatic Steatosis and Stiffness in Adolescent Obesity Are Linked to Androgenemia, Insulin Sensitivity, and Inflammation.Hormone research in paediatrics · 2026Article
- The importance of sex dimorphism in liver metabolism and progressive liver diseases.Biology of sex differences · 2025Review
- Sex Hormones and Metabolic Dysfunction-Associated Steatotic Liver Disease.International journal of molecular sciences · 2025Review
- Sex Differences in Body Composition and MASLD in Children With Overweight and Obesity.Acta paediatrica (Oslo, Norway : 1992) · 2025Article
- Sex Differences in Body Composition and MASLD in Children With Overweight and Obesity.Acta paediatrica (Oslo, Norway : 1992) · 2025Article
- Metabolic dysfunction-associated steatotic liver disease (MASLD) in children with obesity: An Obesity Medicine Association (OMA) and expert joint perspective 2025.Obesity pillars · 2025Review
- Proteomics Used in Identifying Novel Correlates of Disease in Pediatric Metabolic Dysfunction-Associated Steatotic Liver Disease.Clinical and translational science · 2025Article
- The Role of the Liver in the Pathophysiology of PCOS: A Literature Review.Biomolecules · 2025Review
- The Role of SHBG as a Marker in Male Patients with Metabolic-Associated Fatty Liver Disease: Insights into Metabolic and Hormonal Status.Journal of clinical medicine · 2024Article
- Hypogonadism and nonalcoholic fatty liver disease.Endocrine · 2024Review
- Sex-specific differences in ectopic fat and metabolic characteristics of paediatric nonalcoholic fatty liver disease.International journal of obesity (2005) · 2024Article
- Gender differences in non-alcoholic fatty liver disease in obese children and adolescents: a large cross-sectional study.Hepatology international · 2024Article
- Hormonal regulation of metabolism-recent lessons learned from insulin and estrogen.Clinical science (London, England : 1979) · 2023Review
- Sex Hormone-Binding Globulin (SHBG) Reduction: The Alarm Bell for the Risk of Non-Alcoholic Fatty Liver Disease in Adolescents with Polycystic Ovary Syndrome.Children (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
contextSex hormones have been linked with presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults, but it is unknown if they affect severity of pediatric NAFLD.
objectiveTo examine associations of circulating SHBG, estrogens, and androgens with key histologic features of pediatric, biopsy-confirmed NAFLD.
designBaseline assessment of longitudinal cohorts and randomized clinical trials.
settingNonalcoholic Steatohepatitis Clinical Research Network. PATIENTS: Children and adolescents ≤18 years with liver biopsy-confirmed NAFLD in the United States.
main outcome measuresWe assayed SHBG, estrone, estradiol, dehydroepiandrosterone (DHEAS), androstenedione, and testosterone in relation to grade/stage of steatosis, portal inflammation, hepatic ballooning, fibrosis, and nonalcoholic steatohepatitis (NASH) severity using linear regression.
resultsMean age of 573 children at the time of biopsy was 13.1 years (SD 2.8). Lower SHBG was inversely associated with steatosis severity in boys and girls (P = 0.001), and with portal inflammation in girls only (P for sex interaction <0.001). Higher testosterone was related to improved features of steatosis and fibrosis (P for sex interaction = 0.003 and 0.01, respectively) in boys, but detrimental in girls. In boys and girls, higher estrone, estradiol, and testosterone were associated with lower portal inflammation grade; higher estradiol was positively associated with hepatic ballooning severity; DHEAS was inversely associated with hepatic ballooning and NASH severity (all P < 0.05). Androstenedione was not associated with NAFLD features.
conclusionsLargely consistent with findings in adults, sex hormones are associated with distinct histologic features of NAFLD in children and adolescents. These hormone levels relate to differences with gender and pubertal change.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.