title: Sex steroids and sex hormone-binding globulin in postmenopausal women with nonalcoholic fatty liver disease.
abstract: OBJECTIVE
  The evaluation of serum sex steroids and sex hormone-binding globulin (SHBG) levels in postmenopausal women with nonalcoholic fatty liver disease (NAFLD) and their association to the disease severity.
  
  
  METHODS
  Twenty-two postmenopausal women with biopsy-proven NAFLD and 18 matched controls were recruited. Blood samples for serum SHBG, total testosterone, estradiol levels and standard biochemical tests were obtained after overnight fasting. Free androgen index (FAI), calculated free (cFT) and bioavailable testosterone were estimated by standard formulas.
  
  
  RESULTS
  The NAFLD group had lower serum SHBG levels and higher values of cFT, bioavailable testosterone and FAI, despite exhibiting similar to controls levels of serum total testosterone and estradiol. Serum SHBG levels (adjusted odds ratio [aOR]=0.912; 95% CI 0.854-0.973), bioavailable testosterone (aOR=1.254; 95% CI 1.010-1.556) and FAI (aOR=2.567; 95% CI 1.153-5.716), but not cFT, were associated with NAFLD independently of age, body mass index (BMI) and waist circumference. Serum estradiol levels were associated with the presence of nonalcoholic steatohepatitis (NASH) independently of age, BMI and waist circumference (aOR=0.727; 95% CI 0.537-0.985).
  
  
  CONCLUSIONS
  Low SHBG levels and high metabolically active testosterone fractions were independently associated with NAFLD. Among NAFLD patients, serum estradiol levels were independently associated with NASH. However, these results need further validation from large-scale studies.
authors.affiliation: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece.
authors.forename: Stergios A
authors.initials: SA
authors.lastname: Polyzos
authors.forename: Jannis
authors.initials: J
authors.lastname: Kountouras
authors.forename: Agathocles
authors.initials: A
authors.lastname: Tsatsoulis
authors.forename: Efthimia
authors.initials: E
authors.lastname: Zafeiriadou
authors.forename: Evangelia
authors.initials: E
authors.lastname: Katsiki
authors.forename: Kalliopi
authors.initials: K
authors.lastname: Patsiaoura
authors.forename: Christos
authors.initials: C
authors.lastname: Zavos
authors.forename: Vasiliki V
authors.initials: VV
authors.lastname: Anastasiadou
authors.forename: Aristidis
authors.initials: A
authors.lastname: Slavakis
mesh_terms: D003430:Cross-Sectional Studies; D004958:Estradiol / Q000097:blood; D005234:Fatty Liver / Q000097:blood*; D005260:Female; D006801:Humans; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D017698:Postmenopause / Q000097:blood*; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism*; D013739:Testosterone / Q000097:blood*
chemical_list: D012738:Sex Hormone-Binding Globulin; D013739:Testosterone; D004958:Estradiol