2013). Independent of any other comorbidities, mechanisms for lowering testosterone levels in NAFLD patients or animals include high circulatory TGs, decreased circulatory LH levels, low mRNA and protein levels of testicular steroidogenic acute regulatory protein and hepatic sex hormone-binding globulin levels, increased testicular temperature, high testicular inflammation and low numbers of spermatogenic and Leydig cells (Shin et al. 2011; Li et al. 2013; Lia et al. 2015). This evidence concerns the gene STAR and metabolic dysfunction-associated steatotic liver disease.