OBJECTIVE: Elucidate endocrine and metabolic features differentiating polycystic ovary syndrome (PCOS) associated with non-alcoholic fatty liver disease (NAFLD) from PCOS without NAFLD.DESIGN: Retrospective chart review.MATERIALS AND METHODS: Charts from 251 women with PCOS defined by ovulatory dysfunction and hyperandrogenism were reviewed. Sixty-six charts that included liver enzymes determinations were selected for further analysis. All patients had been examined by a single physician (RK). Age, BMI, modified Ferriman-Gallwey (F-G) scores, and endocrine and metabolic data were extracted. Thirteen patients were deemed to have NAFLD based on (1) elevations of AST, ALT, or both, (2) negative hepatitis serology, (3) absence of significant alcohol intake (≤ 1 drink/week), and (4) abdominal ultrasound demonstrating findings characteristic of NALFD in the absence of biliary tract disease. Fifty-one women with PCOS and normal liver enzymes had sufficient data for comparison. Subjects underwent a 3-hour 100g glucose tolerance test with insulin levels. Area under the curve for insulin was calculated using the trapezoidal rule. Statistical analysis was performed using Student's t-test (with logarithmic transformation when necessary). Significance was determined when p < 0.05.RESULTS: Women with PCOS and NAFLD were significantly more obese, more insulin resistant, and demonstrated higher glycemic levels than those without NAFLD.Mean SHBG concentrations were lower in the NAFLD group. All other physical, metabolic, and endocrine parameters (including androgens, lipids, and gonadotropins) were similar.Tabled 1PCOS with NAFLDPCOS without NAFLDMean95% CIMean95% CIpBMI (kg/m2)39.934.0-45.833.531.2-35.90.02Fasting glucose (mg/dL)102.492.9-111.990.087.1-92.90.001HOMA7.694.98-10.404.023.09-4.950.002AUC insulin5942841163-776932270117036-28368<0.0001SHBG (nmol/L)16.99.2-24.541.530.0-54.10.001Free androgen index22.16.2-38.06.94.7-9.20.06 Open table in a new tab OBJECTIVE: Elucidate endocrine and metabolic features differentiating polycystic ovary syndrome (PCOS) associated with non-alcoholic fatty liver disease (NAFLD) from PCOS without NAFLD. DESIGN: Retrospective chart review. MATERIALS AND METHODS: Charts from 251 women with PCOS defined by ovulatory dysfunction and hyperandrogenism were reviewed. Sixty-six charts that included liver enzymes determinations were selected for further analysis. All patients had been examined by a single physician (RK). Age, BMI, modified Ferriman-Gallwey (F-G) scores, and endocrine and metabolic data were extracted. Thirteen patients were deemed to have NAFLD based on (1) elevations of AST, ALT, or both, (2) negative hepatitis serology, (3) absence of significant alcohol intake (≤ 1 drink/week), and (4) abdominal ultrasound demonstrating findings characteristic of NALFD in the absence of biliary tract disease. Fifty-one women with PCOS and normal liver enzymes had sufficient data for comparison. Subjects underwent a 3-hour 100g glucose tolerance test with insulin levels. Area under the curve for insulin was calculated using the trapezoidal rule. Statistical analysis was performed using Student's t-test (with logarithmic transformation when necessary). Significance was determined when p < 0.05. RESULTS: Women with PCOS and NAFLD were significantly more obese, more insulin resistant, and demonstrated higher glycemic levels than those without NAFLD. Mean SHBG concentrations were lower in the NAFLD group. All other physical, metabolic, and endocrine parameters (including androgens, lipids, and gonadotropins) were similar.