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Non-alcoholic fatty liver disease in women with polycystic ovary syndrome: systematic review and meta-analysis.
J Endocrinol Invest. 2017 Dec; 40(12):1279-1288.JE

Abstract

PURPOSE

Non-alcoholic fatty liver disease (NAFLD) is an insidious pathologic condition that can manifest from simple steatosis to steatohepatitis (NASH) with potential progression to cirrhosis. Like the polycystic ovary syndrome (PCOS), NAFLD is associated with obesity, diabetes mellitus, insulin resistance and metabolic syndrome. PCOS women have an increased risk of NAFLD, but it is debatable which features of PCOS, either specific (androgen excess) or unspecific (metabolic derangements) affect the NAFLD risk.

METHODS

We performed a systematic review and meta-analysis of studies that addressed the association of PCOS and NAFLD. We selected 17 studies published between 2007 and 2017 that included 2734 PCOS patients and 2561 controls of similar age and body mass index (BMI).

RESULTS

PCOS patients have increased prevalence of NAFLD (odds ratio 2.54, 95% confidence interval 2.19-2.95). PCOS women with hyperandrogenism (classic phenotype) have a higher prevalence of NAFLD compared to women with PCOS without hyperandrogenism, even after correction for confounding variables. Among women with PCOS, those with NAFLD have higher serum total testosterone (mean difference 0.40 nmol/L, 95% CI 0.29-0.50 nmol/L) and free androgen index (mean difference 4.46, 95% CI 3.53-5.39) than those without NAFLD. The studies that used multivariate analysis controlling for age, BMI, triglycerides, and insulin resistance index confirmed that serum androgens are independent predictors of NAFLD in women with PCOS.

CONCLUSION

The prevalence of NAFLD is increased in women with PCOS and the presence of NAFLD is associated with high serum androgen levels, in addition to obesity and insulin resistance.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.Department of Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.Department of Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.Department of Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.Department of Internal Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.Department of Obstetrics and Gynecology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. fmreis@ufmg.br. Division of Human Reproduction, Departments of Obstetrics and Gynecology, Hospital das Clínicas, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 110, 9˚ andar, Belo Horizonte, MG, 30130-100, Brazil. fmreis@ufmg.br.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

28612285

Citation

Rocha, A L L., et al. "Non-alcoholic Fatty Liver Disease in Women With Polycystic Ovary Syndrome: Systematic Review and Meta-analysis." Journal of Endocrinological Investigation, vol. 40, no. 12, 2017, pp. 1279-1288.
Rocha ALL, Faria LC, Guimarães TCM, et al. Non-alcoholic fatty liver disease in women with polycystic ovary syndrome: systematic review and meta-analysis. J Endocrinol Invest. 2017;40(12):1279-1288.
Rocha, A. L. L., Faria, L. C., Guimarães, T. C. M., Moreira, G. V., Cândido, A. L., Couto, C. A., & Reis, F. M. (2017). Non-alcoholic fatty liver disease in women with polycystic ovary syndrome: systematic review and meta-analysis. Journal of Endocrinological Investigation, 40(12), 1279-1288. https://doi.org/10.1007/s40618-017-0708-9
Rocha ALL, et al. Non-alcoholic Fatty Liver Disease in Women With Polycystic Ovary Syndrome: Systematic Review and Meta-analysis. J Endocrinol Invest. 2017;40(12):1279-1288. PubMed PMID: 28612285.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Non-alcoholic fatty liver disease in women with polycystic ovary syndrome: systematic review and meta-analysis. AU - Rocha,A L L, AU - Faria,L C, AU - Guimarães,T C M, AU - Moreira,G V, AU - Cândido,A L, AU - Couto,C A, AU - Reis,F M, Y1 - 2017/06/13/ PY - 2017/02/22/received PY - 2017/06/05/accepted PY - 2017/6/15/pubmed PY - 2018/7/31/medline PY - 2017/6/15/entrez KW - Infertility KW - Metabolic syndrome KW - Non-alcoholic fatty liver disease KW - Obesity KW - Polycystic ovary syndrome SP - 1279 EP - 1288 JF - Journal of endocrinological investigation JO - J Endocrinol Invest VL - 40 IS - 12 N2 - PURPOSE: Non-alcoholic fatty liver disease (NAFLD) is an insidious pathologic condition that can manifest from simple steatosis to steatohepatitis (NASH) with potential progression to cirrhosis. Like the polycystic ovary syndrome (PCOS), NAFLD is associated with obesity, diabetes mellitus, insulin resistance and metabolic syndrome. PCOS women have an increased risk of NAFLD, but it is debatable which features of PCOS, either specific (androgen excess) or unspecific (metabolic derangements) affect the NAFLD risk. METHODS: We performed a systematic review and meta-analysis of studies that addressed the association of PCOS and NAFLD. We selected 17 studies published between 2007 and 2017 that included 2734 PCOS patients and 2561 controls of similar age and body mass index (BMI). RESULTS: PCOS patients have increased prevalence of NAFLD (odds ratio 2.54, 95% confidence interval 2.19-2.95). PCOS women with hyperandrogenism (classic phenotype) have a higher prevalence of NAFLD compared to women with PCOS without hyperandrogenism, even after correction for confounding variables. Among women with PCOS, those with NAFLD have higher serum total testosterone (mean difference 0.40 nmol/L, 95% CI 0.29-0.50 nmol/L) and free androgen index (mean difference 4.46, 95% CI 3.53-5.39) than those without NAFLD. The studies that used multivariate analysis controlling for age, BMI, triglycerides, and insulin resistance index confirmed that serum androgens are independent predictors of NAFLD in women with PCOS. CONCLUSION: The prevalence of NAFLD is increased in women with PCOS and the presence of NAFLD is associated with high serum androgen levels, in addition to obesity and insulin resistance. SN - 1720-8386 UR - https://www.unboundmedicine.com/medline/citation/28612285/Non_alcoholic_fatty_liver_disease_in_women_with_polycystic_ovary_syndrome:_systematic_review_and_meta_analysis_ L2 - https://link.springer.com/article/10.1007/s40618-017-0708-9 DB - PRIME DP - Unbound Medicine ER -