CHANGES IN ANDROGENIC STATUS DURING THE DEVELOPMENT OF LIVER FIBROSIS IN MEN WITH NON-ALCOHOLIC FAT LIVER DISEASE
Non-alcoholic fatty liver disease is the leading one in the structure of chronic liver diseases. It is widely known about the relationship of non-alcoholic fatty liver disease with abdominal obesity and insulin resistance, which are the basis of metabolic syndrome. Recent studies have shown a decrease in testosterone and sex steroid-binding globulin levels in obese men with insulin resistance, however, the question of the relationship between androgen deficiency and non-alcoholic fatty liver disease in men is not well understood. The aim of this study was to assess the androgenic status of men with non-alcoholic fatty liver disease depending on the stage of fibrosis according to the METAVIR classification and the relationship of indirect biochemical markers of liver fibrosis with the production of sex steroid-binding globulin and testosterone levels. The results of a study of 125 young and middle-aged men (36,4 ± 9,5 years) with non-alcoholic fatty liver disease indicate a close relationship of free testosterone with the development of liver fibrosis. The decrease in sex steroid-binding globulin in non-alcoholic fatty liver disease is explained by the suppression of its production by insulin in obese men, however, a high concentration of sex-steroid-binding globulin may reflect less fat deposition in the liver, and not only in the absence of non-alcoholic fatty liver disease, but also during its progression and the development of fibrosis. Predictors of fibrosis in men with non-alcoholic fatty liver disease are a decrease in the concentration of free calculated testosterone (regression coefficient beta = -0,52, p <0,05), an increase in the level of sexteroid-binding globulin (regression coefficient beta = 0,67, p <0,05) and AST (regression coefficient beta = 0,49, p <0,05).