Male but not female mice in which the aromatase gene has been deleted (ArKO) develop hepatic steatosis that can be normalized by estrogen treatment . Thus, although it is widely recognized that estrogens regulate liver lipid metabolism and reduce triglyceride accumulation in the liver mainly via ER-α 47, 48, both ER-α and GPER are required to be present in the liver to maintain lipid homeostasis. Additionally, treatment of the specific ER-α agonist PPT decreases weight, fat mass, and TG in the liver in both wild-type mice and obese ob/ob mice 39, 40. One study of genome-wide analyses demonstrated that the subtle oscillations of estrogens occurring during the estrous cycle are sufficient to influence liver gene expression, and that ERs are involved in the pulsatile synthesis of fatty acids and cholesterol in the liver . In another E2-deficient aromatase knockout (ArKO) mouse model, spontaneous obesity and hepatic steatosis result from impaired fatty acid β-oxidation and elevated fatty acid synthase (FAS) in the liver in both female and male mice . Epidemiological studies have showed higher plasma level of LDL-C and lower plasma level of HDL-C in men and postmenopausal women compared with premenopausal women, suggesting that lower circulating estrogen levels may promote fat deposition in the liver . It is, therefore, unsurprising that damage to the liver leads to a robust immune response, by both the innate and adaptive arms of the immune system (Figure 5). Since the liver filters all of the blood, it is in a prime position to detect these molecules and sound the alarm to the immune system. The administration of testosterone can accelerate the development of benign prostatic hyperplasia and prostate cancer and increases the risk of breast cancer and cardiovascular disease . Estrogen-only therapy increases a risk for endometrial cancer in menopausal women with a uterus. Although HRT improves liver physiology and function in patients, it also carries risks. Nevertheless, the apparent effect of castration was significantly revealed from our data when T replacement was combined with pulsed GH administration in TXOX rats. Second, incorporation of pulsed GH completely abolished the effect of T on FFAs, but failed to cause any appreciable change on the effects of E2 (33). However, GH plays a central role in this process where other hormones that influence the serum level of GH indirectly affect the expression of the ER gene (11, 12). However, indirect effects of T are more complex mainly due to its crosstalk with ERα- and GHR-mediated signaling pathways. This apparent paradox is in agreement with previous findings (13, 15), where T was shown to promote protein anabolism by inducing amino acid biosynthesis rather than by inhibiting protein catabolism.. Numbers examined for eligibility, confirmed eligible, included in the study, completing follow-up, and analyzed are reported in the "Study design and treatment" subsection The outcomes reported in the present manuscript were changes over time between and within HYPO and HYPO + TTh groups in insulin sensitivity, adipogenic potential and mitochondrial function of preadipocytes (hPADs) isolated from adipose tissue biopsies and in the severity of NAFLD evaluated by triglycerides assay and liver biopsies histology|In addition, TP administration to TXOX rats downregulated genes involved in the metabolism of organic and carboxylic acids, steroid metabolism, regulation of apoptosis, organic acid catabolism or lipid metabolism (Figure 2B). First, we performed a genome-wide analysis of gene expression to better understand the effects of T on liver transcriptome in TXOX rats. As expected, the hepatic mRNA expression levels of gender differentiated genes were affected by TP or pulsatile GH replacement. Hence, this study was conceived in the context of hypothyroid-orchiectomized rats to add comprehensive information about the influence of T replacement, and its interaction with pulsed GH administration, on transcriptome and lipid composition in the male liver. Relevant to this study, thyroid hormones are direct and indirect modulators of hepatic lipid metabolism (25–27).|When GGT is elevated along with ALP, it usually points to a liver or bile duct problem rather than a bone issue. GGT is very sensitive, so even small liver problems may cause it to rise. In the liver, it is located in the bile ducts, which carry bile (a digestive fluid) out of the liver. If AST is much higher than ALT, the cause might be alcohol-related liver damage or another condition outside the liver. When both AST and ALT are elevated, and ALT is higher, liver disease is more likely. A high ALT level can be an early sign of liver problems, even before symptoms show up.|To allow for sufficient muscle glycogen restoration between training sessions and overnight, athletes should consume enough carbohydrates to replace all or at least a substantial amount of the glucose oxidized during the day. Consumption of a variety of carbohydrate foods ensures adequate muscle and liver glycogen restoration between bouts of physical activity. To maintain muscle glycogen stores, athletes are advised to consume a high-carbohydrate diet that contains adequate energy (calories), along with proteins to stimulate muscle repair and growth and fluids to ensure normal hydration. Males and females appear to restore muscle glycogen at similar rates following exercise, as long as sufficient carbohydrates and energy are consumed.98 In older adults, regular exercise training increases the GLUT4 and glycogen content of skeletal muscle, responses similar to those seen in younger adults; however, resting muscle glycogen does not seem to increase to levels seen in younger adults.138,139 Consuming proteins with carbohydrates may be beneficial in stimulating rapid glycogenesis in the hours immediately following exercise,65 a finding that has implications for speeding recovery between demanding bouts of exercise within the same day.|Testosterone treatment to cells for 120 min, and insulin treatment 10 ng ml−1 and 250 ng ml−1 for 60 min, without removing testosterone; the data were analyzed by two-way repeated measures ANOVA test followed by Bonferroni post hoc analysis; data represent mean±s.d. We gave exogenous insulin treatment to the animals, and then checked for P-AKT (Ser-473) and FOXO1 levels in the liver of the two groups. In normal subjects, PEPCK level rises during fasting periods to attain normoglycemia, and in increased insulin resistance conditions also, its level increases resulting in increased hepatic glucose output. Thus, we investigated the effect of testosterone on gluconeogenesis pathway and insulin responsiveness in the liver. Instead, it could have altered signaling in the liver, which led to reduced hepatic glucose output in the testosterone-administered T2DM males.|In addition, the unavoidable daily fluctuations in muscle glycogen stores are an important intracellular signal to stimulate the adaptations required for improved performance,92 augmented intracellular responses that also follow purposeful reductions in muscle glycogen as part of "periodized nutrition" strategies.93 In practical terms, athletes should be educated and encouraged to consume enough carbohydrates to replenish at least a sizable portion of their muscle glycogen stores so that training intensity can be maintained from day to day. In an exhaustive review of the literature on dietary carbohydrate intake among athletes, Burke et al.90 hypothesized that athletes can adapt to lower muscle glycogen stores in ways that protect training capacity and performance. For example, Sherman et al.77 found that participants who were fed moderate- or high-carbohydrate diets (5 vs 10 g/kg BW/d) over 7 days of training were able to maintain their glycogen stores from day to day on the high-carbohydrate diet but experienced a 30%–36% decline in muscle glycogen on the moderate-carbohydrate diet. Athletes who train hard most days of the week, at times completing multiple training sessions each day, likely do so with muscle glycogen stores that are rarely fully replenished. Other researchers89 demonstrated that when individuals consumed a high-glycemic carbohydrate diet (∼10 g carbohydrate/kg BW/d; including corn flakes, bread, potatoes), the muscle glycogen storage rate was 106 mmol/kg wet weight/day (an hourly average of 4.4 mmol/kg wet weight). Athletes typically train with muscle glycogen stores that are adequate to meet the demands of training (eg, between 75 and 150 mmol/kg wet weight) even though those stores might be considered suboptimal.} Muscle glycogen levels can vary widely during training, only reaching supercompensated levels after a few days of rest and light training. It may be that the average value for muscle glycogen concentration does not accurately reflect the intramyofibrillar glycogen stores, which appear to have the greatest impact on muscle function. If daily carbohydrate intake is insufficient to fully replace the glycogen metabolized during hard labor or training, muscle glycogen concentration in active muscles will fall progressively over a period of days, a circumstance that is well established in the scientific literature.75–77 Epinephrine causes phosphorylation of intramyofibrillar glycogen synthase, ensuring that glycogen synthesis is slowed as glycogen degradation rapidly increases.41 The rate of glycogen degradation (glycogenolysis) depends upon exercise intensity; during all-out exercise, glycogen can release glucose molecules at a rate of 40 mmol glucose/kg wet weight/minute. In fact, the second-phase effect can be sustained for several days when carbohydrate intake is maintained.37 Liver glycogen is rapidly restored during postexercise feeding,22 helping ensure the maintenance of normal blood glucose. The second phase depends on insulin and occurs at a slower rate with euglycemia (2–3 mmol/g wet weight/h), a rate that can be increased to 8–12 mmol/g wet weight/hour with additional carbohydrate intake. During the first phase, glycogen synthesis is rapid (12–30 mmol/g wet weight/h), does not require insulin, and lasts 30–40 minutes if glycogen depletion is substantial. Interestingly, such changes cannot be prevented by E2 replacement, which indicates that disrupted liver glucose homeostasis following OVX is not merely caused by deficiency of endogenous E2 but could be caused by deficiency of other ovarian hormones such as progesterone. Additional observations using rodents with OVX that lacks majority of endogenous estrogens support the notion that estrogens lower glucose levels 63, 64. Thus, hepatic steatosis has been observed in both of the above genetic models, one with liver-specific ER-α knockout with functional GPER and the other with liver-specific GPER knockout with functional ER-α. Mice with liver-specific ER-α knockout 44, 45 or liver-specific GPER knockout show increases in fat accumulation in the liver and develop disturbed insulin signaling under high-fat diet (HFD) feeding.