{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:13:22Z","timestamp":1790630002212,"version":"4.1.0"},"reference-count":48,"publisher":"The Endocrine Society","issue":"3","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"PRIN: PROGETTI DI RICERCA DI RILEVANTE INTERESSE NAZIONALE\u2014Bando 2022","award":["2022NCL5JE"],"award-info":[{"award-number":["2022NCL5JE"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Klinefelter syndrome (KS) has a higher propensity for metabolic disorders and increased cardiovascular risk. The prevalence and the characteristics of metabolic dysfunction-associated steatotic liver disease (MASLD) have not been described yet in KS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aim to study the relationship between hypogonadism, liver diseases, and cardiovascular risk using a unique KS model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 82 patients with KS. Data collected included anthropometric measurements, hormonal and liver function parameters, and abdominal ultrasound findings. In a subgroup of 46 patients, hepatic steatosis was evaluated using the control attenuation parameter (CAP) via FibroScan. Cardiovascular risk was assessed using Score2 and Score2-Diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of MASLD in patients with KS was 45.1%. Patients with MASLD were significantly older (P &amp;lt; .001), had higher body mass index (P &amp;lt; .001), waist circumference (P &amp;lt; .001), and a greater prevalence of diabetes (P = .004). In multivariable logistic regression analysis, metabolic syndrome was the only independent predictor of MASLD. For FibroScan\/CAP evaluation, the median liver stiffness (KPa) was 4.7. The median CAP value was 244.0 \u00b1 59.4\u2005dB\/m. Correlation analysis revealed a significant negative relationship between CAP and IGF-1 (P \u2264 .001). In contrast, CAP was positively correlated with triglycerides (P = .020), insulin resistance index (P = .017), waist circumference (P &amp;lt; .001), and body mass index (P \u2264 .001). Cardiovascular risk showed no significant differences between the MASLD and non-MASLD groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This first study highlights substantial MASLD prevalence in patients with KS (45.1%). Metabolic syndrome is the major independent predictor of MASLD with a negative correlation between CAP and IGF-1. Early identification of MASLD is crucial to address the elevated risk of metabolic complications in this vulnerable population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf479","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:43:39Z","timestamp":1756295019000},"page":"e868-e876","source":"Crossref","is-referenced-by-count":8,"title":["Metabolic Dysfunction-associated Steatotic Liver Disease in Klinefelter Syndrome: High Prevalence Uncovers an Unmet Need"],"prefix":"10.1210","volume":"111","author":[{"given":"Aldo","family":"Marrone","sequence":"first","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli , 80138 Naples 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