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Related Concept Videos

Infertility in Males01:23

Infertility in Males

Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural...
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Evolution
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Sex-linked Disorders

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The Bidirectional Association Between MASLD and Male Hypogonadism: An Updated Meta-Analysis.

Giorgia Spaggiari1,2,3, Leonardo Dalla Valentina1,2, Cristina Felicani4

  • 1Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.

Andrology
|July 10, 2026
PubMed
Summary

Testosterone deficiency is linked to metabolic dysfunction-associated steatotic liver disease (MASLD) in men. Lower testosterone levels correlate with higher MASLD prevalence and severity, suggesting an endocrine-hepatic axis requiring further investigation.

Keywords:
MASLDhypogonadismlivertestosterone

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Area of Science:

  • Endocrinology
  • Hepatology
  • Metabolic Health

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) and male hypogonadism are prevalent and interconnected conditions.
  • Testosterone (T) deficiency may contribute to liver fat accumulation, insulin resistance, and obesity.
  • MASLD might negatively impact the male reproductive endocrine system.

Purpose of the Study:

  • To systematically review and perform a meta-analysis on the bidirectional relationship between circulating testosterone levels and MASLD in adult men.

Main Methods:

  • A systematic literature search adhering to PRISMA guidelines was conducted up to July 31, 2025.
  • Twenty-eight studies were included, comparing hypogonadal vs. eugonadal men and MASLD vs. non-MASLD men.
  • Random-effects models and meta-regression analyses were employed to assess associations and influencing factors.

Main Results:

  • Hypogonadal men had a significantly higher prevalence and fatty liver index scores of MASLD.
  • Men with MASLD exhibited significantly lower total testosterone and sex hormone-binding globulin levels.
  • Age was the only significant modifier; no significant differences were found for LH, estradiol, or FIB-4 index.

Conclusions:

  • A clinically significant association exists between testosterone deficiency and MASLD, supporting an endocrine-hepatic axis.
  • Testosterone deficiency appears independently associated with MASLD onset and severity, beyond age and adiposity.
  • Reciprocal screening for liver and gonadal health in at-risk men is recommended; further research on T deficiency treatment is warranted.