Nonalcoholic fatty liver disease in women with polycystic ovary syndrome: associated factors and noninvasive fibrosis staging in a single Brazilian center.

Daniela Oliveira De Lima Taranto,Fernando M Reis,Ana Lúcia Cândido,Rosana Correa Silva Azevedo,Luciana C Faria,Thais Cristine Moura Guimarães,Ana Luiza L Rocha,Claudia A Couto,Fernanda Souza Mattos,Maria Luiza Cândido Elias

doi:10.20945/2359-3997000000242

Daniela Oliveira De Lima Taranto, Fernando M Reis + Show 8 more

Open Access

https://doi.org/10.20945/2359-3997000000242

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Journal: Archives of Endocrinology and Metabolism	Publication Date: Jun 5, 2020
Citations: 10	License type: cc-by

Abstract

Polycystic ovary syndrome (PCOS) is a recognized risk factor for nonalcoholic fatty liver disease (NAFLD). The aims of this study were to investigate the prevalence and factors associated with NAFLD in women with PCOS and evaluate noninvasive indices of hepatic fibrosis in patients with PCOS and NAFLD. Patients with PCOS (n = 87) and women without PCOS (n = 40; controls) were included. NAFLD was diagnosed by abdominal ultrasonography after exclusion of alcohol consumption and viral or autoimmune liver disease. Anthropometric, clinical and metabolic variables, homeostasis model assessment of insulin resistance (HOMA-IR) index, lipid accumulation product (LAP), FIB-4 index, NAFLD score, and transient elastography (TE; FibroScan) were obtained in subsets of patients with PCOS and NAFLD. A total of 87 patients with PCOS were included (mean age: 34.4 ± 5.7 years, mean body mass index [BMI]: 34.7 ± 4.7 kg/m 2 ). NAFLD was present in 67 (77.0%) patients with PCOS versus 21 of 40 (52.5%) controls (p = 0.005). Women with PCOS and liver steatosis, compared with their NAFLD-free counterparts, had higher values of BMI, waist circumference, triglycerides, total cholesterol, alanine and aspartate aminotransferases, and γ-glutamyltransferase, along with higher frequencies of obesity, metabolic syndrome, and insulin resistance. NAFLD was independently associated with waist circumference, serum triglycerides, and alanine aminotransferase levels. The FIB-4 index was not compatible with advanced fibrosis in any of the evaluated patients, while NAFLD score and TE were compatible with advanced liver fibrosis in 1 of 26 (3.8%) and 3 of 25 (12%) patients, respectively. Women with PCOS had a high risk of NAFLD, and a combination of both was associated with central obesity, dyslipidemia, insulin resistance, and metabolic syndrome. Noninvasive methods suggested low rates of severe hepatic fibrosis in Brazilian women with PCOS. Arch Endocrinol Metab. 2020;64(3):235-42.

Highlights

Nonalcoholic fatty liver disease (NAFLD) is a spectrum of clinical and pathological conditions that can manifest as simple steatosis, with accumulation of lipids in the liver parenchyma, or nonalcoholic steatohepatitis (NASH), characterized by hepatocyte injury, inflammation, and fibrosis in patients without significant alcohol consumption
The prevalence of hepatic steatosis detected by ultrasonography was higher in the Polycystic ovary syndrome (PCOS) group (77.0%) than the control group (52.5%) (p = 0.005) (Table 1)
We compared the prevalence of hepatic steatosis in patients with PCOS versus a control group of women with similar body mass index (BMI) and waist circumference (WC) and without a diagnosis of PCOS

Summary

Introduction

Nonalcoholic fatty liver disease (NAFLD) is a spectrum of clinical and pathological conditions that can manifest as simple steatosis, with accumulation of lipids in the liver parenchyma, or nonalcoholic steatohepatitis (NASH), characterized by hepatocyte injury, inflammation, and fibrosis in patients without significant alcohol consumption. Univariate logistic regression was performed to assess the association between steatosis and the following variables: age, BMI, WC, phenotype of PCOS, levels of TC, LDL, HDL, TG, TT, AST, ALT, GGT, HOMA-IR, LAP, VAI, and presence of hyperandrogenism, MS, IR, hypertension, DM, IGT, obesity, and central adiposity.

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