He YF, Bian N, Wang HZ, Hu XD, Liu JQ, Lu SF, Wu N, He QT, Li HM. Correlation between non-alcoholic fatty liver disease and erectile dysfunction: A systematic narrative review. World J Hepatol 2026; 18(4): 115456 [DOI: 10.4254/wjh.v18.i4.115456]
Corresponding Author of This Article
Yan-Fei He, MD, Associate Chief Physician, Department of Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, No. 6 Fucheng Road, Haidian District, Beijing 100048, China. heyanfeilc@163.com
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Endocrinology & Metabolism
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Systematic Reviews
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Apr 27, 2026 (publication date) through Apr 22, 2026
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World Journal of Hepatology
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1948-5182
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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He YF, Bian N, Wang HZ, Hu XD, Liu JQ, Lu SF, Wu N, He QT, Li HM. Correlation between non-alcoholic fatty liver disease and erectile dysfunction: A systematic narrative review. World J Hepatol 2026; 18(4): 115456 [DOI: 10.4254/wjh.v18.i4.115456]
World J Hepatol. Apr 27, 2026; 18(4): 115456 Published online Apr 27, 2026. doi: 10.4254/wjh.v18.i4.115456
Correlation between non-alcoholic fatty liver disease and erectile dysfunction: A systematic narrative review
Yan-Fei He, Ning Bian, Huan-Zhi Wang, Xiao-Dong Hu, Jun-Qiang Liu, Shuang-Feng Lu, Ni Wu, Qin-Tong He, Hu-Ming Li
Yan-Fei He, Ning Bian, Shuang-Feng Lu, Ni Wu, Department of Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
Huan-Zhi Wang, Department of College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, Gansu Province, China
Xiao-Dong Hu, Department of Endocrinology, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
Jun-Qiang Liu, Department of Thoracic Surgery, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
Qin-Tong He, Department of School of Public Health and Health Sciences, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
Hu-Ming Li, Department of Respiratory Medicine, The Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
Author contributions: He YF contribution to design the study, review the literature, and write the initial manuscript; Bian N and Wang HZ contribution to retrieve and summarize the literature; Hu XD, Liu JQ, and He QT contribution to offer advice on the review and reviewed the final manuscript; Lu SF, Wu N, and Li HM contribution to collect and analyze relevant data for the article during the revision process; and all authors contributed to the article and approved the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Yan-Fei He, MD, Associate Chief Physician, Department of Health Management Center, The Sixth Medical Center, Chinese PLA General Hospital, No. 6 Fucheng Road, Haidian District, Beijing 100048, China. heyanfeilc@163.com
Received: October 17, 2025 Revised: November 23, 2025 Accepted: February 5, 2026 Published online: April 27, 2026 Processing time: 186 Days and 19.3 Hours
Abstract
BACKGROUND
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, as well as a growing public health concern. Erectile dysfunction (ED) is one of the most common sexual dysfunctions in men. Currently, clinical research on the relationship between NAFLD and ED is limited.
AIM
To systematically review and narrative synthesize the existing evidence on the association between NAFLD and ED, and to elucidate potential underlying mechanisms.
METHODS
We conducted a comprehensive search of various electronic databases to identify original observational studies investigating the association between NAFLD and ED. However, due to significant heterogeneity among the included studies and the limited number of eligible investigations, we opted for a narrative synthesis instead of a meta-analysis.
RESULTS
A total of seven observational studies, involving 4442 participants (2043 of whom had NAFLD), were included in the analysis. The evidence consistently indicates a significant positive association between NAFLD and ED. Key influencing factors identified across the studies included age, components of metabolic syndrome, insulin resistance, serum testosterone levels, and psychological factors such as anxiety.
CONCLUSION
Existing evidence indicates a strong correlation between NAFLD and ED. The strength of this association is influenced by various factors, including age, insulin resistance, testosterone levels, and anxiety. NAFLD is an important risk factor for ED. Further high-quality studies are needed to confirm this relationship and explain its underlying mechanisms.
Core Tip: Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver condition worldwide. It often occurs alongside metabolic disorders, such as obesity and type 2 diabetes. Erectile dysfunction (ED) is a common sexual health issue in men. However, there is limited high-quality evidence systematically examining the relationship between ED and NAFLD. This systematic narrative review summarizes the existing research and confirms that NAFLD is a significant risk factor for ED. The strength of this association depends on various factors, including age, insulin resistance, testosterone levels, and anxiety. This study provides evidence-based support for the early identification of ED risk in NAFLD patients, which is significant for advancing comprehensive metabolic interventions, both socially and clinically.
