Commentary
The association of free testosterone with NASH was determined in pre-menopausal women with biopsy-confirmed NAFLD. Interaction testing was performed for age and free testosterone given decline in testosterone with age, and association of aging with NASH.
In this study, higher free testosterone levels were associated with NAFLD severity in younger women. In young women with NAFLD, higher testosterone levels conferred a 2-fold higher risk of NASH and NASH fibrosis, and increased risk of abdominal adiposity.
Free testosterone was additionally associated with abdominal adiposity among all pre-menopausal women.
Testosterone may represent an early risk factor for NASH progression in young women, prior to their onset of more dominant, age-related metabolic risk factors.