The Fatty Liver Index, the Strongest Risk Factor for Low Testosterone Level

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Luna Liu, Man Li, Pengcheng Chen, Yuchen Li, Qianmei Song, Junming Han, Li Fang, Qingbo Guan, Chunxiao Yu

Abstract​

Introduction: The study aimed to determine if hepatic steatosis assessed by Fatty Liver Index (FLI) was an independent risk factor for male testosterone insufficiencylow testosterone level and whether the FLI was the strongest risk factor for testosterone insufficiencylow testosterone level in two different age groups.
Methods: Two cross-sectional studies were performed. A total of 3443 male participants (aged 46-75) were recruited into study A (part of lONgitudinal study (REACTION)). Then a total of 267 male participants (aged 25-45) were recruited into study B. Serum TT and sex hormone-binding globulin (SHBG) levels, indicators for assessing hepatic steatosis were measured. The Pearson correlation and regression analysis were performed to investigate the risk factors for testosterone insufficiencylow testosterone level.
Results: The FLI had the strongest negative correlation with serum testosterone in the study A (r=-0.436) and B (r=-0.542). Compared with patients with a FLI lower than 30, the risk for testosterone insufficiencylow testosterone level increased by 3.48-fold in subjects with a FLI higher than 60 adjusted for potential risk factors in study A. In study B, the OR of testosterone insufficiencylow testosterone level in patients with potential hepatic steatosis was 4.26 (1.57-11.60) after adjusted for age and HOMA-IR, and 0.59 (0.14-2.60) after adjusted for age, HOMA-IR, waist circumference, body mass index, and SHBG.
Conclusions: FLI, was the strongest risk factor for male testosterone insufficiencylow testosterone level independent of insulin resistance in a male populations of different ages, however the association can be modulated by SHBG levels in the young.
The Author(s). Published by S. Karger AG, Basel.
 
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According to a Washington Post investigation between 2017 and 2021, diagnoses in children under seventeen of nonalcoholic fatty liver disease more than doubled. It’s estimated that 5% to 10% of all U.S. children now have it, making it as common as asthma.

Tying these two studies together.....Sedentary life styles in children is also causing fatty liver disease. Sedentary lifestyles lead to obesity, so that combined with a diet high in sugars seems to be a big culprit which most likely leads to low testosterone.


 
I just learned this.


To calculate the fatty liver index (FLI), you can use the following formula:

FLI = (e0.953×loge(triglycerides)+0.139×BMI+0.718×loge(GGT)+0.053×waist circumference−15.745)/ (1 + e0.953×loge(triglycerides)+0.139×BMI+0.718×loge(GGT)+0.053×waist circumference−15.745) × 100

Where:
- BMI is the body mass index
- GGT is the gamma-glutamyl-transferase
- Waist circumference is measured in centimeters
- Triglycerides are measured in mg/dL

This formula was developed by Bedogni et al. in 2006 and is based on waist circumference, BMI, triglycerides, and GGT levels[2][4][5]. The resulting FLI score ranges from 0 to 100, with higher scores indicating a higher likelihood of hepatic steatosis or fatty liver disease[2][3][5]. The FLI is a non-invasive method of assessing hepatic steatosis and is easy to employ as each individual component is a routine measurement in clinical practice[4][5].

Sources
[1] Fatty Liver Index - MDCalc Fatty Liver Index
[2] The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population - PMC - NCBI The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population
[3] The fatty liver index, a simple and useful predictor of metabolic syndrome: analysis of the Korea National Health and Nutrition Examination Survey 2010–2011 - PMC - NCBI The fatty liver index, a simple and useful predictor of metabolic syndrome: analysis of the Korea National Health and Nutrition Examination Survey 2010–2011
[4] Validation of the Fatty Liver Index for Nonalcoholic Fatty L... : Medicine - Lippincott Validation of the Fatty Liver Index for Nonalcoholic Fatty... : Medicine
[5] Fatty Liver Index (FLI) Calculator - MDApp Fatty Liver Index (FLI) Calculator
[6] The Alcoholic Liver Disease/Nonalcoholic Fatty Liver Disease Index (ANI) - Medical Professionals - Mayo Clinic The Alcoholic Liver Disease/Nonalcoholic Fatty Liver Disease Index (ANI) - Medical Professionals - Mayo Clinic

By Perplexity at https://www.perplexity.ai/search/9bdb1a54-e680-4be4-9f95-cfff744ce3f6
 
Beyond Testosterone Book by Nelson Vergel

J Nanobiotechnology
. 2024 Sep 28;22(1):591.
doi: 10.1186/s12951-024-02864-z.

Leveraging adrenergic receptor blockade for enhanced nonalcoholic fatty liver disease treatment via a biomimetic nanoplatform​

Bingyuan Fei 1, Yuewu Zhao 2, Jine Wang 2, Panyue Wen 3, Junjie Li 3, Masaru Tanaka 3, Zheng Wang 4, Shuo Li 5
Affiliations Expand

Abstract​

Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive lipid accumulation, steatosis and fibrosis. Sympathetic nerves play a critical role in maintaining hepatic lipid homeostasis and regulating fibrotic progression through adrenergic receptors expressed by hepatocytes and hepatic stellate cells; however, the use of sympathetic nerve-focused strategies for the treatment of NAFLD is still in the infancy. Herein, a biomimetic nanoplatform with ROS-responsive and ROS-scavenging properties was developed for the codelivery of retinoic acid (RA) and the adrenoceptor antagonist labetalol (LA). The nanoplatform exhibited improved accumulation and sufficient drug release in the fibrotic liver, thereby achieving precise codelivery of drugs. Integration of adrenergic blockade effectively interrupted the vicious cycle of sympathetic nerves with hepatic stellate cells (HSCs) and hepatocytes, which not only combined with RA to restore HSCs to a quiescent state but also helped to reduce hepatic lipid accumulation. We demonstrated the excellent ability of the biomimetic nanoplatform to ameliorate liver inflammation, fibrosis and steatosis. Our work highlights the tremendous potential of a sympathetic nerve-focused strategy for the management of NAFLD and provides a promising nanoplatform for the treatment of NAFLD.
Keywords: Adrenoceptor blockade; Biomimetic nanoplatform; Hepatic stellate cells; Liver steatosis; Nonalcoholic fatty liver disease.
© 2024. The Author(s).

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References​

    1. Younossi ZM, Golabi P, Paik JM, Henry A, Van Dongen C, Henry L. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology. 2023;77:1335–47. - DOI - PubMed
    1. Paik JM, Henry L, Younossi Y, Ong J, Alqahtani S, Younossi ZM. The burden of nonalcoholic fatty liver disease (NAFLD) is rapidly growing in every region of the world from 1990 to 2019. Hepatol Commun. 2023;7:e0251. - DOI - PubMed - PMC
    1. Pafili K, Roden M. Nonalcoholic fatty liver disease (NAFLD) from pathogenesis to treatment concepts in humans. Mol Metabolism. 2021;50:101122. - DOI
    1. Luo Y, Lin H. Inflammation initiates a vicious cycle between obesity and nonalcoholic fatty liver disease. Immun Inflamm Dis. 2021;9:59–73. - DOI - PubMed
    1. Zhang LF, Deng WQ, Huang QW, Zhang JJ, Wang Y, Zhou TJ, Xing L, Jiang HL. Vicious cycle-breaking lipid nanoparticles remodeling multicellular crosstalk to reverse liver fibrosis. Adv Mater. 2024;36(16):2311474.
 
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