Testosteron Tedavisinin Hipogonad Hastalardaki Non-Alkolik Yağlı Karaciğer Hastalığı Üzerine Etkisinin Fibroscan ile Değerlendirilmesi

Yıl 2022, Cilt: 17 Sayı: 1, 186 - 192, 21.03.2022

Murat İspiroğlu

https://doi.org/10.17517/ksutfd.1055412

Öz

Giriş: Hipogonadizm, metabolik sendrom ve non-alkolik yağlı karaciğer hastalığı (NAYKH) ile yakın ilişki içindedir. Çalışmamızda hipogonad hastalara uygulanan testesteron tedavisi ile non-alkolik yağlı karaciğer hastalığı ilişkisini Fibroscan ve laboratuar veriler ile incelemeyi amaçladık.
Materyal-Metod: Çalışmaya 18-60 yaş arasında, yeni tanı veya son 6 aydır androjen replasman tedavisi almayan 40 hipogonad erkek (hasta grubu) ve yaş, vücut kitle indeksi (VKİ) benzer 36 ögonad erkek (kontrol grubu) alındı. Tüm katılımcıların VKİ, bel çevresi ölçüldü. Laboratuvar parametrelerinden açlık plazma glukozu, açlık insülin değeri, karaciğer fonksiyon testleri, hormon ve lipid paneli ölçüldü. Ayrıca tüm katılımcıların Fibroscan® (transient elastografi) işlemi yapılarak, hepatosteatoz düzeyi (CAP skoru) değerlendirildi.
Bulgular: Çalışmamızda hipogonad grupta kontrol grubuna göre ortalama (CAP skoru) hepatosteatoz düzeyi daha yüksek izlendi (sırasıyla, 274.72±78.69 dB/m ve 207.41±52.82 dB/m, p=0,000). Testesteron tedavisi sonrası hipogonad grup ortalama bel çevresi, hepatosteatoz düzeyi ve laboratuar değerlerinde (AST, ALT, Açlık plazma glikoz, Total-K, LDL, TG, insülin) gerileme izlendi. Ancak bunlardan AST, ALT, LDL-K, TG, total testesteron düzeyi, bel çevresi ve ek olarak vücut kitle indeksi direk ortalama hepatosteatoz düzeyi ile korelasyon gösterdi. Lojistik regresyon analizi yapıldığında hepatosteatozu predikte eden en anlamlı parametre total testesteron düzeyi olduğu saptandı (OR: 0,004, %95 C.I: 0,988-0,998).
Sonuç: Hipogonadizmli erkek hastalarda ögonad erkeklere göre NAYKH sıklığı artmıştır. Total testesteron düzeyi, VKİ, Bel Çevresi artışı NAYKH gelişiminde bağımsız risk faktörleridir. Bu nedenle testesteron replasman tedavisinin NAYKH ve eşlik eden metabolik sendrom parametrelerini iyileştirebileceğini düşünmekteyiz.

Anahtar Kelimeler

Hipogonadizm, non-alkolik yağlı karaciğer hastalığı, Testesteron, fibroscan

Destekleyen Kurum

yok

Evaluation of the Effect of Testosterone Treatment on Non-Alcoholic Fatty Liver Disease in Hypogonad Patients with Fibroscan

Öz

Introduction: It is closely associated with hypogonadism, metabolic syndrome and non-alcoholic fatty liver disease (NAFLD). In our study, we aimed to examine the relationship between testosterone treatment applied to hypogonad patients and non-alcoholic fatty liver disease using Fibroscan and laboratory data.
Material-method: Forty hypogonads and 36 eugonads aged 8-60 years without treatment were included in the study. BMI, waist circumference and laboratory measurements (glucose, liver function tests, hormone and lipid panel) of all participants were measured. In addition, hepatosteatosis level was evaluated with Fibroscan® (transient elastography) procedure.
Results: In our study, the mean (CAP score) hepatosteatosis level of the hypogonad group was higher than the control group (274. 72±78.69 dB/m and 207. 41±52.82 dB/m, p=0.000, respectively). After testosterone treatment, a decrease was observed in the mean waist circumference, hepatosteatosis level and laboratory values (AST, ALT, Fasting plasma glucose, Total-C, LDL, TG, insulin) of the hypogonad group. However, of these, AST, ALT, LDL-C, TG, total testosterone level, waist circumference and additionally body mass index were directly correlated with the mean hepatosteatosis level. When logistic regression analysis was performed, the most significant parameter predicting hepatosteatosis was found to be total testosterone level (OR: 0.004, 95% CI: 0.988-0.998).
Conclusion: The incidence of NAFLD is increased in male patients with hypogonadism compared to eugonad males. Total testosterone level, BMI, Waist Circumference are independent risk factors for the development of NAFLD. Therefore, we think that testosterone replacement therapy can improve NAFLD and accompanying metabolic syndrome parameters.

Anahtar Kelimeler

Hypogonadism, Non-alcoholic fatty liver disease, Testosterone, Fibroscan.

Kaynakça

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