Low testosterone is associated with steatosis in the male population with spinal cord injury

To determine the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in men with spinal cord injury (SCI) and to identify the independent factors associated with steatosis.

This is a cross-sectional study. Inclusion criteria were males over 18 years of age with chronic traumatic SCI enrolled in a rehabilitation programme. A multivariable logistic regression model was constructed using a stepwise variable selection procedure.

After exclusion criteria, 160 participants were included. The prevalence of MASLD was 19%. Men with hepatic steatosis were older, had a higher prevalence of hypogonadism, obesity and diabetes mellitus. Additionally, they exhibited significantly higher levels of ALT, AST and GGT. The mean time since the SCI was 7.8 years in those with steatosis and 4.3 years in those without. Multiple logistic regression analysis revealed age (p < 0.001 OR: 1.07), time since SCI (p = 0.025, OR: 1.11) and total testosterone ≤ 300 ng/dL (p = 0.036, OR: 3.35) as significant independent variables associated with steatosis.

Our findings suggest a prevalence of MASLD in men with SCI similar to that of the general population. Independent factors associated with steatosis were age, time since injury and total testosterone. Notably, individuals with testosterone levels ≤ 300 ng/dL were 3.35 times more likely to have steatosis compared to those with higher testosterone levels.