Meta-analysis links fatty liver disease with lower testosterone in men

A 2026 systematic review and meta-analysis found an association between MASLD and testosterone deficiency in adult men, with lower total testosterone levels seen in men with fatty liver disease. MOPE Clinic in Metairie is highlighting the research as a reminder that metabolic and hormone concerns often overlap and require medical evaluation, not guesswork.

Why it matters: - The findings add to evidence that metabolic dysfunction-associated steatotic liver disease, or MASLD, and low testosterone often appear together in adult men. - The results may affect how clinicians evaluate fatigue, low libido, body composition changes and other symptoms that can stem from multiple causes. - The analysis underscores a key point: an association between two conditions does not prove that one causes the other.

What happened: - A 2026 systematic review and meta-analysis examined the relationship between MASLD and testosterone deficiency in men. - The peer-reviewed analysis included 28 studies. - Nine studies compared men with hypogonadism and men with normal testosterone status. - Nineteen studies compared men with MASLD and men without the condition. - Researchers found MASLD was significantly more prevalent among men with hypogonadism. - Researchers also found total testosterone concentrations were significantly lower among men with MASLD than among control groups. - MOPE Clinic in Metairie is highlighting the research as part of patient education on metabolic and hormone health. - Chris Rue, APRN, FNP-C, of MOPE Clinic said, “The research reinforces why metabolic and hormone concerns should be evaluated with laboratory data, medical history and the patient's overall health picture.” - The research is indexed on PubMed as the 2026 systematic review and meta-analysis. - More information is available in the PubMed record.

The details: - MASLD is the newer term for a form of fatty liver disease linked to metabolic dysfunction. - MASLD was previously widely known as nonalcoholic fatty liver disease, or NAFLD. - The National Institute of Diabetes and Digestive and Kidney Diseases says people with MASLD often have few or no symptoms. - When symptoms do appear, fatigue or discomfort in the upper-right portion of the abdomen may occur. - Some people only learn they have MASLD after abnormal liver-related findings show up on laboratory testing, imaging or other medical evaluation. - MASLD often overlaps with overweight or obesity, insulin resistance, type 2 diabetes, abnormal blood lipid levels and metabolic syndrome. - These conditions can also affect cardiovascular risk, blood glucose regulation and body composition. - Testosterone affects reproductive and sexual function, muscle mass, bone health and body composition. - Testosterone levels can also be influenced by age, obesity, chronic medical conditions, medications and other health factors. - Across the studies analyzed, men with hypogonadism had a higher prevalence of MASLD. - Men with MASLD had lower total testosterone concentrations than men without MASLD. - Several included studies also found relationships between testosterone levels and the severity of liver disease. - The authors called for additional long-term research and randomized clinical trials. - MOPE Clinic says laboratory testing is required before treatment decisions are made. - MOPE Clinic combines test results with symptoms, medical history and individual health considerations when evaluating patients. - General habits that can support metabolic health include regular physical activity, balanced meals, limiting sugary drinks, maintaining muscle and prioritizing sleep. - Indoor walking, resistance exercise and other climate-controlled activities may be useful alternatives during extreme South Louisiana heat and humidity. - Persistent snoring, breathing pauses during sleep or ongoing daytime exhaustion may warrant evaluation for a sleep disorder. - MOPE Clinic also points patients to additional educational material on fatty liver and low testosterone at the clinic's educational page.

Between the lines: - The analysis adds weight to a broader clinical theme: metabolic health and hormone health are intertwined, and symptoms alone are not enough to identify the cause. - Shared factors such as obesity, insulin resistance, sleep disorders, medication use, age and chronic illness may influence both MASLD and testosterone levels. - That overlap helps explain why a single abnormal lab result or symptom cannot provide a complete diagnosis. - The clinic's message also reflects a prevention and screening approach, especially for patients with multiple metabolic risk factors.

What's next: - Researchers say more prospective studies are needed to clarify how MASLD and testosterone deficiency relate over time. - Randomized clinical trials may help determine whether treating one condition changes the other. - Clinicians are likely to continue using laboratory testing, history and symptom review to separate overlapping causes of fatigue, weight change and other complaints. - MOPE Clinic says it will continue using laboratory testing and individualized clinical planning for hormone and metabolic concerns.

The bottom line: - MASLD and low testosterone are linked in men, but current evidence points to overlap, not proven cause and effect.