The Association between Metabolic Dysfunction-Associated Steatotic Liver Disease and Hypogonadism in Male Patients: A Systematic Review and Meta-Analysis

Polpichai N, Saowapa S, Wattanachayakul P, Danpanichkul P, Chan SY and Trongtorsak A

Published on: 2024-05-03

Abstract

Background and Aim

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) represents a significant global health concern, often associated with various metabolic disorders. Recent research has highlighted a potential association between MASLD and hypogonadism in males, characterized by decreased reproductive hormone levels. This study aims to explore the association between MASLD and hypogonadism in male patients.

Methods

A systematic review and meta-analysis were conducted using articles from PubMed, PMC, Scopus, Web of Science, and the Cochrane database. REVMAN 5.4 statistical software was employed for the meta-analysis, utilizing a random-effects model, 95% confidence interval, and standardized mean differences. Study quality was assessed using the AXIS checklist for cross-sectional studies.

Results

Fifteen studies involving 12,582 males with or without MASLD underwent quality appraisal. The primary outcome was the mean total testosterone levels in each cohort. Analysis revealed a statistically significant reduction in total mean testosterone levels among MASLD patients compared to those without MASLD (SMD -0.33 nmol/L, 95% CI -0.50, -0.15, P=0.0002). Significant heterogeneity (I2=92%, P<0.00001) was observed, attributed to differences in study designs and proportions.

Conclusion

This investigation establishes a significant association between MASLD and low testosterone levels in male patients.