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High-free androgen index is associated with increased risk of non-alcoholic fatty liver disease in women with polycystic ovary syndrome, independent of obesity and insulin resistance.
Int J Obes (Lond). 2017 09; 41(9):1341-1347.IJ

Abstract

BACKGROUND/OBJECTIVE

Central obesity and insulin resistance (IR) are common conditions in women with polycystic ovary syndrome (PCOS) and in subjects with non-alcoholic fatty liver disease (NAFLD). However, few studies have addressed the association between hyperandrogenism (HA) and NAFLD. We aimed to determine whether variations in the free androgen index (FAI) might be associated with NAFLD prevalence.

SUBJECTS/METHODS

A cross-sectional study was performed including 400 Chinese women with PCOS and 100 age, and body mass index (BMI)-matched women. The anthropometric and serum biochemical parameters related to sex steroids, glucose and lipid profiles were examined. Liver fat content (LFC) was measured by quantitative ultrasound.

RESULTS

The prevalence of NAFLD was 56.23% in PCOS patients and 38% in controls (P=0.001), and this prevalence increased with FAI quartile independently of obesity and homeostasis model assessment of insulin resistance (HOMA-IR). The FAI level increased from non-NAFLD group to NAFLD group. The FAI was positively associated with the metabolic parameters LFC, BMI, waist circumference, alanine aminotransferases, aspartate, triglyceride, total cholesterol and low-density lipoprotein cholesterol, and was negatively associated with high-density lipoprotein. Moreover, in multivariate logistic regression analysis BMI, high-sensitivity C-reactive protein (hsCRP), FAI, LFC and HOMA-IR were significantly associated with NAFLD. The cut-off values of FAI, LFC, BMI and hsCRP to predict NAFLD were 9.86%, 17.19%, 24.38% and 0.72%, respectively. The area under the curve for predicting NAFLD in PCOS patients showed comparable sensitivity and specificity between BMI and a new index combining FAI with hsCRP.

CONCLUSIONS

A higher FAI level is associated with increased LFC and NAFLD prevalence independent of obesity and IR.

Authors+Show Affiliations

Division of Endocrinology and Metabolism, Department of Internal Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Division of Ultrasonography, Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Division of Endocrinology and Metabolism, Department of Internal Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Division of Endocrinology and Metabolism, Department of Internal Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Division of Endocrinology and Metabolism, Department of Internal Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Division of Endocrinology and Metabolism, Department of Internal Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Division of Endocrinology and Metabolism, Department of Internal Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Division of Endocrinology and Metabolism, Department of Internal Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Division of Endocrinology and Metabolism, Department of Internal Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Shanghai Key laboratory for Assisted Reproduction and Reproductive Genetics, Center for Reproductive Medicine, Shanghai Jiaotong University School of Medicine, Pudong, Shanghai, China.Division of Endocrinology and Metabolism, Department of Internal Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.Division of Endocrinology and Metabolism, Department of Internal Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28487551

Citation

Cai, J, et al. "High-free Androgen Index Is Associated With Increased Risk of Non-alcoholic Fatty Liver Disease in Women With Polycystic Ovary Syndrome, Independent of Obesity and Insulin Resistance." International Journal of Obesity (2005), vol. 41, no. 9, 2017, pp. 1341-1347.
Cai J, Wu CH, Zhang Y, et al. High-free androgen index is associated with increased risk of non-alcoholic fatty liver disease in women with polycystic ovary syndrome, independent of obesity and insulin resistance. Int J Obes (Lond). 2017;41(9):1341-1347.
Cai, J., Wu, C. H., Zhang, Y., Wang, Y. Y., Xu, W. D., Lin, T. C., Li, S. X., Wang, L. H., Zheng, J., Sun, Y., Liu, W., & Tao, T. (2017). High-free androgen index is associated with increased risk of non-alcoholic fatty liver disease in women with polycystic ovary syndrome, independent of obesity and insulin resistance. International Journal of Obesity (2005), 41(9), 1341-1347. https://doi.org/10.1038/ijo.2017.116
Cai J, et al. High-free Androgen Index Is Associated With Increased Risk of Non-alcoholic Fatty Liver Disease in Women With Polycystic Ovary Syndrome, Independent of Obesity and Insulin Resistance. Int J Obes (Lond). 2017;41(9):1341-1347. PubMed PMID: 28487551.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - High-free androgen index is associated with increased risk of non-alcoholic fatty liver disease in women with polycystic ovary syndrome, independent of obesity and insulin resistance. AU - Cai,J, AU - Wu,C H, AU - Zhang,Y, AU - Wang,Y Y, AU - Xu,W D, AU - Lin,T C, AU - Li,S X, AU - Wang,L H, AU - Zheng,J, AU - Sun,Y, AU - Liu,W, AU - Tao,T, Y1 - 2017/05/10/ PY - 2017/01/30/received PY - 2017/04/07/revised PY - 2017/04/23/accepted PY - 2017/5/11/pubmed PY - 2018/7/3/medline PY - 2017/5/11/entrez SP - 1341 EP - 1347 JF - International journal of obesity (2005) JO - Int J Obes (Lond) VL - 41 IS - 9 N2 - BACKGROUND/OBJECTIVE: Central obesity and insulin resistance (IR) are common conditions in women with polycystic ovary syndrome (PCOS) and in subjects with non-alcoholic fatty liver disease (NAFLD). However, few studies have addressed the association between hyperandrogenism (HA) and NAFLD. We aimed to determine whether variations in the free androgen index (FAI) might be associated with NAFLD prevalence. SUBJECTS/METHODS: A cross-sectional study was performed including 400 Chinese women with PCOS and 100 age, and body mass index (BMI)-matched women. The anthropometric and serum biochemical parameters related to sex steroids, glucose and lipid profiles were examined. Liver fat content (LFC) was measured by quantitative ultrasound. RESULTS: The prevalence of NAFLD was 56.23% in PCOS patients and 38% in controls (P=0.001), and this prevalence increased with FAI quartile independently of obesity and homeostasis model assessment of insulin resistance (HOMA-IR). The FAI level increased from non-NAFLD group to NAFLD group. The FAI was positively associated with the metabolic parameters LFC, BMI, waist circumference, alanine aminotransferases, aspartate, triglyceride, total cholesterol and low-density lipoprotein cholesterol, and was negatively associated with high-density lipoprotein. Moreover, in multivariate logistic regression analysis BMI, high-sensitivity C-reactive protein (hsCRP), FAI, LFC and HOMA-IR were significantly associated with NAFLD. The cut-off values of FAI, LFC, BMI and hsCRP to predict NAFLD were 9.86%, 17.19%, 24.38% and 0.72%, respectively. The area under the curve for predicting NAFLD in PCOS patients showed comparable sensitivity and specificity between BMI and a new index combining FAI with hsCRP. CONCLUSIONS: A higher FAI level is associated with increased LFC and NAFLD prevalence independent of obesity and IR. SN - 1476-5497 UR - https://www.unboundmedicine.com/medline/citation/28487551/High_free_androgen_index_is_associated_with_increased_risk_of_non_alcoholic_fatty_liver_disease_in_women_with_polycystic_ovary_syndrome_independent_of_obesity_and_insulin_resistance_ L2 - https://doi.org/10.1038/ijo.2017.116 DB - PRIME DP - Unbound Medicine ER -