Department of Geriatrics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
Department of Geriatrics, the Tenth People's Hospital of Shanghai, Tongji University, Shanghai, China.
BMC Geriatr. 2021 Oct 12;21(1):544. doi: 10.1186/s12877-021-02490-6.
Recent studies have suggested the significant relationship between follicle-stimulating hormone (FSH) and non-alcoholic fatty liver disease (NAFLD) in postmenopausal women. However, it is unknown whether FSH impacts the risk of NAFLD in men. This study aimed to investigate the association between serum FSH levels and NAFLD in elderly Chinese men aged 80-98, a particular group with worse outcomes of NAFLD.
A cross-sectional analysis was performed in 444 subjects in a geriatric health center. The highest quartile of serum FSH was used as reference. Hepatic steatosis was defined according to the results of liver ultrasound. Fibrosis-4 (FIB-4) Index > 2.67 was defined as advanced fibrosis.
Based on liver ultrasound, 108 (24.3%) subjects had NAFLD. FSH level were negatively correlated with total testosterone, estradiol, nutritional risk, and the prevalence of high education level (all P < 0.01), and positively correlated with age, luteinizing hormone, alanine aminotransferase and aspartate aminotransferase (all P < 0.05). The correlation between FSH and body mass index or antihypertensive drug usage was marginally significant (P = 0.057; P = 0.066, respectively). The percentage of subjects with NAFLD had a trend to increase following the quartiles of serum FSH (20.0% in quartile 1, 18.2% in quartile 2, 27.3% in quartile 3, and 31.6% in quartile 4). After adjustment for common pathogenic risk factors, nutritional risk, and other sex hormones, serum FSH were progressively associated with odds ratios for NAFLD. The adjusted odds ratios and 95% CIs for quartile 1, quartile 2, and quartile 3, compared with quartile 4 were 0.132 (0.034-0.516), 0.190 (0.052-0.702), and 0.404 (0.139-1.173), respectively. Obesity was not involved in the potential negative role of circulating FSH on the risk of NAFLD in our population. Furthermore, our results revealed no significant association between FSH and advance fibrosis, the OR (95% CI) for advanced fibrosis was 1.018 (0.983-1.054) (P = 0.316) after adjusting for the potential covariates, although a positive correlation of FSH and FIB-4 score was observed (r = 0.325, P = 0.001).
Low FSH level may decrease the risk of NAFLD in elderly Chinese men. These findings warrant replication in more extensive studies.
最近的研究表明，在绝经后妇女中，卵泡刺激素（FSH）与非酒精性脂肪性肝病（NAFLD）之间存在显著关系。然而，尚不清楚 FSH 是否会影响男性患 NAFLD 的风险。本研究旨在探讨血清 FSH 水平与 80-98 岁中国老年男性中 NAFLD 的关系，这是一组 NAFLD 结局更差的特定人群。
对老年保健中心的 444 名受试者进行了横断面分析。以血清 FSH 最高四分位数为参照。根据肝脏超声结果定义肝脂肪变性。纤维 4 指数（FIB-4）>2.67 定义为晚期纤维化。
根据肝脏超声，108 名（24.3%）受试者患有 NAFLD。FSH 水平与总睾酮、雌二醇、营养风险和高教育程度的患病率呈负相关（均 P<0.01），与年龄、黄体生成素、丙氨酸氨基转移酶和天冬氨酸氨基转移酶呈正相关（均 P<0.05）。FSH 与体重指数或使用降压药之间的相关性具有显著意义（P=0.057；P=0.066）。血清 FSH 四分位数的受试者中 NAFLD 的比例呈上升趋势（四分位数 1 为 20.0%，四分位数 2 为 18.2%，四分位数 3 为 27.3%，四分位数 4 为 31.6%）。调整常见致病风险因素、营养风险和其他性激素后，血清 FSH 与 NAFLD 的比值比呈逐步相关。与四分位数 4 相比，四分位数 1、四分位数 2 和四分位数 3 的调整比值比和 95%CI 分别为 0.132（0.034-0.516）、0.190（0.052-0.702）和 0.404（0.139-1.173）。在我们的人群中，肥胖并未涉及循环 FSH 对 NAFLD 风险的潜在负面作用。此外，尽管观察到 FSH 与 FIB-4 评分呈正相关（r=0.325，P=0.001），但我们的结果显示 FSH 与晚期纤维化之间无显著关联，调整潜在协变量后，晚期纤维化的 OR（95%CI）为 1.018（0.983-1.054）（P=0.316）。
低 FSH 水平可能会降低中国老年男性患 NAFLD 的风险。这些发现需要在更广泛的研究中得到证实。
