Testosterone treatment improves liver function and reduces cardiovascular risk: A long-term prospective study

Area of Science:

• Endocrinology
• Hepatology
• Cardiology

Background:

• Hypogonadism is associated with metabolic dysfunction, including hepatic steatosis and increased cardiovascular disease (CVD) risk.
• Testosterone therapy (TTh) aims to restore testosterone levels, but its long-term effects on liver health and CVD in hypogonadal men require further investigation.

Purpose of the Study:

• To investigate the association between long-term testosterone undecanoate (TU) treatment and liver function in hypogonadal men.
• To assess the impact of TU on hepatic steatosis, non-alcoholic fatty liver disease (NAFLD), and cardiovascular disease (CVD) risk markers.

Main Methods:

• A prospective study involving 496 hypogonadal men, divided into a treatment group (312 patients receiving TU 1000 mg every 12 weeks for 8 years) and an untreated control group (184 patients).
• Evaluation of liver function, Fatty Liver Index (FLI), metabolic parameters (BMI, waist circumference, triglycerides), and mortality rates.

Main Results:

• The testosterone treatment group showed significant reductions in FLI, bilirubin, triglycerides, and gamma-glutamyl-transferase (γ-GT).
• Improvements were also observed in body mass index (BMI) and waist circumference (WC) in the treatment group.
• Cardiovascular disease (CVD)-related mortality was lower in the testosterone treatment group (7.8%) compared to the control group (15.2%).

Conclusions:

• Long-term testosterone therapy in hypogonadal men is associated with improved liver function and reduced markers of hepatic steatosis.
• The observed physiological improvements in the liver may contribute to a decrease in CVD-related mortality.