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Furthermore, lifestyle interventions combined with testosterone therapy are particularly effective in preventing and reversing T2D, especially in obese patients with low testosterone levels [147, 360,361,362]

K.ChapmanE.et al (2015)

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At baseline, 18.3% of patients had diabetes, 20% had advanced fibrosis or cirrhosis, the average MELD-Na score was 9.1, and the average BMI was 28.4

Moreover, compromised intestinal barrier integrity and gut-derived microbial components such as LPS activate TLR/NF-B/NLRP3 pathways, which not only drive systemic inflammation but also modulate gut-derived tryptophan metabolism and serotonin synthesis, thereby coupling immune regulation with neuromodulatory functions