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Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome

BACKGROUND: Polycystic ovary disease (PCOS) may be a risk factor for nonalcoholic fatty liver disease (NAFLD) due to common pathogenetic pathways, including insulin resistance and obesity. Both PCOS and NAFLD are more severe in South Asian women. Data on NAFLD in South Asian women with PCOS are lack...

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Autores principales: Shengir, Mohamed, Krishnamurthy, Srinivasan, Ghali, Peter, Deschenes, Marc, Wong, Philip, Chen, Tianyan, Sebastiani, Giada
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2020
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701948/
https://www.ncbi.nlm.nih.gov/pubmed/33311949
http://dx.doi.org/10.3748/wjg.v26.i44.7046
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author Shengir, Mohamed
Krishnamurthy, Srinivasan
Ghali, Peter
Deschenes, Marc
Wong, Philip
Chen, Tianyan
Sebastiani, Giada
author_facet Shengir, Mohamed
Krishnamurthy, Srinivasan
Ghali, Peter
Deschenes, Marc
Wong, Philip
Chen, Tianyan
Sebastiani, Giada
author_sort Shengir, Mohamed
collection PubMed
description BACKGROUND: Polycystic ovary disease (PCOS) may be a risk factor for nonalcoholic fatty liver disease (NAFLD) due to common pathogenetic pathways, including insulin resistance and obesity. Both PCOS and NAFLD are more severe in South Asian women. Data on NAFLD in South Asian women with PCOS are lacking. AIM: To investigate prevalence and predictors of NAFLD and liver fibrosis in PCOS patients from South Asia. METHODS: We conducted an observational routine screening program by means of transient elastography (TE) with associated controlled attenuation parameter (CAP). NAFLD was defined as CAP ≥ 288 decibels per meter. Significant liver fibrosis (stage 2 and higher out of 4) was defined as TE measurement ≥ 8.0 kilopascals. Elevated alanine aminotransferase (ALT) was defined as ALT > 24 IU/L, as per upper limit of normal reported in South Asian women. Biochemical hyperandrogenism was defined as free androgen index > 5. Predictors of NAFLD were determined by logistic regression analysis. RESULTS: 101 PCOS patients (mean age 36.3 years) with no significant alcohol intake or viral hepatitis were included. Prevalence of NAFLD and significant liver fibrosis was 39.6% and 6.9%, respectively. Elevated ALT was observed in 40% and 11.5% of patients with and without NAFLD, respectively. After adjusting for duration of PCOS and insulin resistance measured by homeostasis model for assessment of insulin resistance, independent predictors of NAFLD were higher body mass index [adjusted odds ratio (aOR) 1.30, 95% confidence interval (CI): 1.13-1.52], hyperandrogenism (aOR: 5.32, 95%CI: 1.56-18.17) and elevated ALT (aOR: 3.54, 95%CI: 1.10-11.47). Lifetime cardiovascular risk was higher in patients with NAFLD compared to those without NAFLD (0.31 ± 0.11 vs 0.26 ± 0.13). CONCLUSION: Despite their young age, NAFLD diagnosed by TE with CAP is a frequent comorbidity in South Asian women with PCOS and is strongly associated with higher body mass index and hyperandrogenism. Non-invasive screening strategies could help early diagnosis and initiation of interventions, including counselling on weight loss, cardiovascular risk stratification and linkage to hepatology care where appropriate.
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spelling pubmed-77019482020-12-10 Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome Shengir, Mohamed Krishnamurthy, Srinivasan Ghali, Peter Deschenes, Marc Wong, Philip Chen, Tianyan Sebastiani, Giada World J Gastroenterol Observational Study BACKGROUND: Polycystic ovary disease (PCOS) may be a risk factor for nonalcoholic fatty liver disease (NAFLD) due to common pathogenetic pathways, including insulin resistance and obesity. Both PCOS and NAFLD are more severe in South Asian women. Data on NAFLD in South Asian women with PCOS are lacking. AIM: To investigate prevalence and predictors of NAFLD and liver fibrosis in PCOS patients from South Asia. METHODS: We conducted an observational routine screening program by means of transient elastography (TE) with associated controlled attenuation parameter (CAP). NAFLD was defined as CAP ≥ 288 decibels per meter. Significant liver fibrosis (stage 2 and higher out of 4) was defined as TE measurement ≥ 8.0 kilopascals. Elevated alanine aminotransferase (ALT) was defined as ALT > 24 IU/L, as per upper limit of normal reported in South Asian women. Biochemical hyperandrogenism was defined as free androgen index > 5. Predictors of NAFLD were determined by logistic regression analysis. RESULTS: 101 PCOS patients (mean age 36.3 years) with no significant alcohol intake or viral hepatitis were included. Prevalence of NAFLD and significant liver fibrosis was 39.6% and 6.9%, respectively. Elevated ALT was observed in 40% and 11.5% of patients with and without NAFLD, respectively. After adjusting for duration of PCOS and insulin resistance measured by homeostasis model for assessment of insulin resistance, independent predictors of NAFLD were higher body mass index [adjusted odds ratio (aOR) 1.30, 95% confidence interval (CI): 1.13-1.52], hyperandrogenism (aOR: 5.32, 95%CI: 1.56-18.17) and elevated ALT (aOR: 3.54, 95%CI: 1.10-11.47). Lifetime cardiovascular risk was higher in patients with NAFLD compared to those without NAFLD (0.31 ± 0.11 vs 0.26 ± 0.13). CONCLUSION: Despite their young age, NAFLD diagnosed by TE with CAP is a frequent comorbidity in South Asian women with PCOS and is strongly associated with higher body mass index and hyperandrogenism. Non-invasive screening strategies could help early diagnosis and initiation of interventions, including counselling on weight loss, cardiovascular risk stratification and linkage to hepatology care where appropriate. Baishideng Publishing Group Inc 2020-11-28 2020-11-28 /pmc/articles/PMC7701948/ /pubmed/33311949 http://dx.doi.org/10.3748/wjg.v26.i44.7046 Text en ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Observational Study
Shengir, Mohamed
Krishnamurthy, Srinivasan
Ghali, Peter
Deschenes, Marc
Wong, Philip
Chen, Tianyan
Sebastiani, Giada
Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome
title Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome
title_full Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome
title_fullStr Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome
title_full_unstemmed Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome
title_short Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome
title_sort prevalence and predictors of nonalcoholic fatty liver disease in south asian women with polycystic ovary syndrome
topic Observational Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701948/
https://www.ncbi.nlm.nih.gov/pubmed/33311949
http://dx.doi.org/10.3748/wjg.v26.i44.7046
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