ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2021
Testosterone is Associated With Nonalcoholic Steatohepatitis and Fibrosis in Premenopausal Women With NAFLD.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 23 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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.
Pilot Trial of Bicalutamide Versus Placebo in Reproductive-Aged Women With Nonalcoholic Fatty Liver Disease (NAFLD) and Polycystic Ovary Syndrome (PCOS)
Androgens and Nonalcoholic Fatty Liver Disease (NAFLD) In Reproductive-Aged Women With and Without Polycystic Ovary Syndrome (PCOS)
Who cites it
23 citing papers in PubMed, 38 citations in OpenAlex.
- Sex Steroids Regulate Liver Fat Content and Body Fat Distribution in Both Men and Women: A Study in Transgender Persons.The Journal of clinical endocrinology and metabolism · 2023Trial
- MASLD, diabetes and PMOS across the female life stages.Diabetologia · 2026Review
- Ultrasound grading of hepatic steatosis and its metabolic and endocrine correlates among adults with MASLD in Duhok, Iraq: a cross-sectional study.Journal of ultrasound · 2026Article
- Disparities in liver-related care among transgender adults with steatotic liver disease: a retrospective cohort study.Journal of the Endocrine Society · 2026Article
- The regulation of intrahepatic fatty acid partitioning within the human liver: the effect of sex.Clinical science (London, England : 1979) · 2026Review
- From Childhood to Old Age: Current Knowledge and Practical Approaches to Metabolic Dysfunction-Associated Steatotic Liver Disease.Journal of clinical medicine · 2026Review
- DESIGN AND VALIDATION OF A BUNDLE FOR ASSESSING GONADAL FUNCTION IN INDIVIDUALS WITH LIVER CIRRHOSIS.Arquivos de gastroenterologia · 2026Review
- The importance of sex dimorphism in liver metabolism and progressive liver diseases.Biology of sex differences · 2025Review
- Association of liver fibrosis-4 index with functional outcomes in chinese patients with acute ischemic stroke undergoing mechanical thrombectomy.Scientific reports · 2025Article
- Transgender Women with HIV Demonstrate Unique Non-Alcoholic Fatty Liver Disease Profiles.Transgender health · 2024Article
- Hyperandrogenism and Cardiometabolic Risk in Pre- and Postmenopausal Women-What Is the Evidence?The Journal of clinical endocrinology and metabolism · 2024Review
- NAFLD Fibrosis Progression and Type 2 Diabetes: The Hepatic-Metabolic Interplay.Life (Basel, Switzerland) · 2024Review
- Antimullerian Hormone, a Marker of Ovarian Reserve, Is Protective Against Presence and Severity of NASH in Premenopausal Women.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2024Article
- Estrogen-ER-α axis induces PNPLA3 p.I148M protein variant to promote steatotic liver disease susceptibility in women.Clinical and translational medicine · 2024Article
- Sex differences in chronic liver disease and benign liver lesions.JHEP reports : innovation in hepatology · 2023Review
- Cullin-associated and neddylation-dissociated protein 1 (CAND1) alleviates NAFLD by reducing ubiquitinated degradation of ACAA2.Nature communications · 2023Article
- The Associations Between Alanine Aminotransferase and Other Biochemical Parameters in Lean PCOS.Reproductive sciences (Thousand Oaks, Calif.) · 2023Review
- Comprehensive Review of Cardiovascular Disease Risk in Nonalcoholic Fatty Liver Disease.Journal of cardiovascular development and disease · 2022Review
- Non-alcoholic fatty liver disease through the female lifespan: the role of sex hormones.Journal of endocrinological investigation · 2022Review
- Premenopausal Syndrome and NAFLD: A New Approach Based on Gender Medicine.Biomedicines · 2022Review
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsHigher testosterone contributes to imaging-confirmed nonalcoholic fatty liver disease (NAFLD) in women, but whether testosterone influences their disease severity is unknown.
methodsThe association of free testosterone (free T) with nonalcoholic steatohepatitis (NASH) was determined in pre-menopausal women with biopsy-confirmed NAFLD (n = 207). Interaction testing was performed for age and free T given decline in testosterone with age, and association of aging with NASH. Regression models adjusted for abdominal adiposity, diabetes, and dyslipidemia.
resultsMedian age was 35 yrs (interquartile range, 29-41); 73% were white, 25% Hispanic; 32% had diabetes, 93% abdominal adiposity, and 95% dyslipidemia. 69% had NASH, 67% any fibrosis, and 15% advanced fibrosis. Higher free T levels were associated with NAFLD severity in younger women (interaction P value <.02). In the youngest age quartile, free T was independently associated with NASH (odds ratio [OR], 2.3; 95% CI, 1.2-4.4), NASH fibrosis (OR, 2.1; 95% CI, 1.1-3.8), and higher fibrosis stage (OR, 1.9; 95% CI, 1.1-3.4), P value .02. In these women, the proportion with NASH steadily rose from 27% to 88%, and with NASH fibrosis rose from 27% to 81%, with higher free T quartiles (P < .01). Free T was additionally associated with abdominal adiposity among all pre-menopausal women (OR, 2.2; 95% CI, 1.2-4.1: P = .02).
conclusionsIn young women with NAFLD, higher testosterone levels conferred a 2-fold higher risk of NASH and NASH fibrosis, and increased risk of abdominal adiposity, supporting a potential mechanistic link of abdominal fat on testosterone-associated liver injury. Testosterone may represent an early risk factor for NASH progression in young women, prior to their onset of more dominant, age-related metabolic risk factors.
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What OpenQuestion holds
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.