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. 2018 Nov;63(3):238-245.
doi: 10.3164/jcbn.18-30. Epub 2018 Jun 8.

Clinical Efficacy of Free Androgen Index, a Surrogate Hallmark of Circulating Free Testosterone Level, in Male Patients With HCV-related Chronic Liver Disease

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Free PMC article

Clinical Efficacy of Free Androgen Index, a Surrogate Hallmark of Circulating Free Testosterone Level, in Male Patients With HCV-related Chronic Liver Disease

Takashi Himoto et al. J Clin Biochem Nutr. .
Free PMC article

Abstract

The role of free testosterone, that not bound to sex hormone-binding globulin, in male patients with HCV infection remains uncertain. We investigated whether free testosterone is involved in the progression to hepatic fibrosis/steatosis or insulin resistance in male patients with HCV-related chronic liver disease or not. Free androgen indices, which reflect circulating free testosterone levels, were calculated as 100 × total testosterone levels/sex hormone-binding globulin levels in 30 male patients with HCV-related chronic liver disease. Degrees of hepatic fibrosis and steatosis were evaluated by the New Inuyama Classification and the classification proposed by Brunt and colleagues, respectively. Insulin resistance was estimated by HOMA-IR values. Serum total testosterone levels were independent of hepatic fibrosis staging in the enrolled patients. However, circulating sex hormone-binding globulin levels were significantly increased in proportion to the severity of hepatic fibrosis. Therefore, free androgen indices were inversely correlated with the severity of hepatic fibrosis. Moreover, free androgen indices were inversely correlated with the grades of hepatic steatosis and HOMA-IR values in those patients. Our data suggest that lower circulating free testosterone levels may be recognized as the risk factor for more advanced hepatic fibrosis, steatosis and/or higher insulin resistance in male patients with HCV-related chronic liver disease.

Keywords: HCV; free androgen index; hepatic fibrosis; hepatic steatosis; insulin resistance.

Conflict of interest statement

No potential conflicts of interest were disclosed.

Figures

Fig. 1
Fig. 1
Relationship between serum total testosterone and SHBG levels in male patients with CLD-C. CLD-C, HCV-related chronic liver disease; SHBG, sex hormone-binding globulin.
Fig. 2
Fig. 2
Relationships between the degrees of hepatic fibrosis and (a) total testosterone levels, (b) SHBG levels or (c) FAIs in male CLD-C patients. The boxes represent the values within 25th and 75th percentiles. The horizontal bars represent the medians. CLD-C, HCV-related chronic liver disease; FAI, free androgen index; SHBG, sex hormone-binding globulin.
Fig. 3
Fig. 3
Relationships between the grade of hepatic steatosis and (a) total testosterone levels, (b) SHBG levels or (c) FAIs in male CLD-C patients. The boxes represent the values within 25th and 75th percentiles. The horizontal bars represent the medians. CLD-C, HCV-related chronic liver disease; FAI, free androgen index; SHBG, sex hormone-binding globulin.
Fig. 4
Fig. 4
Relationships between HOMA-IR values and (a) total testosterone levels, (b) SHBG levels or (c) FAIs in male CLD-C patients. CLD-C, HCV-related chronic liver disease; FAI, free androgen index; HOMA-IR, homeostasis model for assessment of insulin resistance; SHBG, sex hormone-binding globulin.
Fig. 5
Fig. 5
Relationships between FAIs and (a) serum ALT levels, (b) serum T-Cho levels, (c) serum TG levels or (d) BMIs in male CLD-C patients. ALT, alanine aminotransferase; BMI, body mass index; CLD-C, HCV-related chronic liver disease; FAI, free androgen index; T-Cho, total cholesterol; TG, triglyceride.
Fig. 6
Fig. 6
Relationships between FAIs and (a) loads of HCV RNA or (b) HCV genotypes. The boxes represent the values within 25th and 75th percentiles. The horizontal bars represent the medians.
Fig. 7
Fig. 7
Relationships between HOMA-IR values and the degrees of (a) hepatic fibrosis or (b) hepatic steatosis in male patients with CLD-C. The boxes represent the values within 25th and 75th percentiles. The horizontal bars represent the medians. CLD-C, HCV-related chronic liver disease; HOMA-IR, homeostasis model for assessment of insulin resistance.

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