Free Testosterone Is Associated With Worse Survival in Patients With Advanced Chronic Liver Disease Awaiting Liver Transplantation
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Le résumé fourni par la source
BACKGROUND AND AIMS: Hypogonadism is frequent in AdvCLD and associated with frailty and poor outcomes. This study aimed to evaluate the association between free testosterone (FT) levels and all-cause mortality in male patients with AdvCLD awaiting liver transplantation (LT), and to compare the prognostic value of FT with total testosterone (TT). METHODS: In this prospective cohort study, 191 male patients with AdvCLD awaiting LT underwent FT and TT evaluation. The primary outcome was all-cause mortality, assessed using a competing-risk model with LT as the competing event. RESULTS: Among the 191 patients, 41 (21.5%) had low FT levels. This group was more likely to have a higher Child-Turcotte-Pugh class and MELD-Na score, as well as higher proportion of individuals with a history of hepatic encephalopathy (HE) compared to those with normal FT levels (p < 0.05). Patients with low FT also exhibited greater frailty (liver frailty index: 4.2 ± 0.8 vs. 3.6 ± 0.9, p < 0.001, respectively). After adjustment for MELD-Na, low FT was significantly associated with increased mortality risk (adjusted subdistribution hazard ratio [aSHR] 1.97; 95% CI: 1.07-3.61). Additionally, patients with low FT had a lower cumulative probability of undergoing LT compared to those with normal FT levels (43.4% vs. 74.3%). In contrast, low TT was not associated with mortality (aSHR: 1.65; 95% CI: 0.90-3.02). CONCLUSION: Low FT levels are independently associated with higher mortality and lower LT probability in men with AdvCLD and outperform TT as a prognostic marker. These findings support FT as a valuable biomarker to identify high-risk patients and guide future interventional strategies.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Free Testosterone Is Associated With Worse Survival in Patients With Advanced Chronic Liver Disease Awaiting Liver Transplantation
- Date Crossref
- 25/11/2025
- Éditeur
- Wiley
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Clinica Universidad de Navarra Liver Unit pays non établi dans la noticeÉtablissement de santé
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Brigham and Women's Hospital Department of Gastroenterology and Hepatology pays non établi dans la noticeÉtablissement de santé
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University of Pittsburgh Starzl Transplantation Institute pays non établi dans la noticeUniversité ou école supérieure
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University of Pittsburgh Medical Center pays non établi dans la noticeÉtablissement de santé
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Northwestern University pays non établi dans la noticeUniversité ou école supérieure
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Northwestern Medicine pays non établi dans la noticeÉtablissement de santé
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Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán pays non établi dans la noticeStructure de recherche
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Department of Urology Northwestern Feinberg School of Medicine Chicago Illinois USA Department of Urology pays non établi dans la noticeUniversité ou école supérieure
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Division of Gastroenterology and Hepatology Northwestern Feinberg School of Medicine Chicago Illinois USA pays non établi dans la noticeUniversité ou école supérieure
Liver Unit — Clinica Universidad de Navarra, Department of Gastroenterology and Hepatology — Brigham and Women's Hospital et Starzl Transplantation Institute — University of Pittsburgh, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.