Mechanisms of hepatic steatosis formation in adolescent boys with hypoandrogenism

There has been an increase the prevalence of andrological diseases in all age groups in recent decades, including those with comorbid conditions such as pathology of the cardiovascular system and liver, which are manifestations of metabolic syndrome. Research aim: to investigate the relationship between formation of hepatic steatosis and hypoandrogenism (HA) in adolescent boys. Materials and methods. The study involved 42 adolescent boys aged 14–18 years with laboratory confirmed HA in whom total testosterone levels were less than 12.0 nmol/l. Sex hormones, gonadotropins, insulin levels, biochemical parameters of liver function, the state of free radical oxidation and antioxidant protection were determined in patients. Based on ultrasound examination adolescents with HA were divided into 2 groups: group 1 – 15 adolescents with signs of liver steatosis; group 2 – 27 adolescents with normal ultrasound parameters of a liver. The control group consisted of 38 boys of the same age with normal indicators of physical and sexual development without signs of pathology of the hepatobiliary system. Results. Individual assessment of sexual development allowed to diagnose I degree of delayed sexual development in 44.7%, II degree in 38.3% and III degree in 17.0% of adolescents. HA negatively affects the physical development of most boys (78.7%), due to short stature (40.0%), weight deficiency (20.0%) and overweight (18.7%). Factor analysis allowed to build a factor model of hepatic steatosis formation in adolescents with delayed sexual development and HA, which describes 76.0% of the sample and consists of five factors. Conclusion. Atherogenic changes of the lipid profile, androgen deficiency, insulin resistance, activation of cytolytic processes in the liver and oxidative stress formation due to a decrease in the effectiveness of antioxidant protection are important in the pathogenesis of hepatic steatosis in boys with HA. A factor model of the hepatic steatosis development in adolescent boys with HA gives grounds for the development of therapeutic and preventive measures in adolescent boys with HA and comorbid liver pathology.