Association of sex hormones with non‐alcoholic fatty liver disease: An observational and Mendelian randomization study

孟德尔随机化 性激素结合球蛋白 激素 脂肪肝 医学 内科学 睾酮(贴片) 疾病 内分泌学 生理学 生物 遗传学 基因 基因型 雄激素 遗传变异
作者
Chenghao Weng,Zilun Shao,Meng Xiao,Mingyu Song,Yuxuan Zhao,Aolin Li,Yuanjie Pang,Tao Huang,Canqing Yu,Jun Lv,Liming Li,Dianjianyi Sun
出处
期刊:Liver International [Wiley]
卷期号:44 (5): 1154-1166 被引量:1
标识
DOI:10.1111/liv.15866
摘要

Abstract Background and Aims Sex‐specific associations of sex hormone‐binding globulin (SHBG) and bioavailable testosterone (BAT) with NAFLD remain indeterminate. We aimed to explore observational and genetically determined relationships between each hormone and NAFLD. Methods We included 187 395 men and 170 193 women from the UK Biobank. Linear and nonlinear Cox regression models and Mendelian randomization (MR) analysis were used to test the associations. Results During 12.49 years of follow‐up, 2209 male and 1886 female NAFLD cases were documented. Elevated SHBG levels were linearly associated with a lower risk of NAFLD in women (HR (95% CI), .71 (.63, .79)), but not in men (a “U” shape, p non‐linear < .001). Higher BAT levels were associated with a lower NAFLD risk in men (HR (95% CI), .81 (.71, .93)) but a higher risk in women (HR (95% CI): 1.25 (1.15, 1.36)). Genetically determined SHBG and BAT levels were linearly associated with NAFLD risk in women (OR (95% CI): .57 (.38, .87) and 2.21 (1.41, 3.26) respectively); in men, an “L‐shaped” MR association between SHBG levels and NAFLD risk was found ( p non‐linear = .016). The bidirectional MR analysis further revealed the effect of NAFLD on SHBG and BAT levels in both sexes. Conclusions Consistently, linear associations of lower SHBG and higher BAT levels with increased NAFLD risk were both conventionally and genetically found in women, while in men, SHBG acts in a nonlinear manner. In addition, NAFLD may affect SHBG and BAT levels.
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