Prevalence of nonalcoholic fatty liver disease in women with polycystic ovary syndrome.
OBJECTIVE
Insulin resistance has been implicated in the pathogenesis of both nonalcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS). We hypothesized that NAFLD would be common in both obese and nonobese women with PCOS. The aim of this study was to estimate the prevalence of and identify associated factors for hepatic steatosis in women with PCOS.


METHODS
This is a retrospective study of 88 consecutive premenopausal women with PCOS. Clinical history, height, weight, and laboratory values were obtained. Fasting measurements of serum glucose and insulin were used to calculate homeostasis model assessment of insulin resistance (HOMA-IR). Abdominal ultrasonography was used to determine the presence and severity of hepatic steatosis.


RESULTS
Of the 88 women (median age, 31.4 years), 48 (55%) had steatosis; 15 (39%) of them were lean women. The presence of steatosis was associated with a greater body mass index (BMI) (P = .005) and HOMA-IR (P = .033), a lower fasting high-density lipoprotein (P = .003), and a greater prevalence of impaired fasting glucose, impaired glucose tolerance, and diabetes mellitus (P = .013). Only 7 (15%) subjects with hepatic steatosis had abnormal liver chemistries.


CONCLUSIONS
Fatty liver was identified in 55% of subjects with PCOS, nearly 40% of whom were lean women. High BMI and insulin resistance appeared to be important associated factors. Early recognition of NAFLD in this group of young patients is warranted, and further investigation including liver biopsy might be indicated.
Gambarin-Gelwan
Maya
M
Division of Gastroenterology and Hepatology, Weill Medical College of Cornell University, New York, NY 10021, USA. mag2046@med.cornell.edu
Kinkhabwala
Sanjiv V
SV
Schiano
Thomas D
TD
Bodian
Carol
C
Yeh
Hsu-Chong
HC
Futterweit
Walter
W
D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D015897:Comorbidity; D005234:Fatty Liver / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011336:Probability; D012016:Reference Values; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric