title: Nonalcoholic fatty liver disease in menopausal women.
abstract: BACKGROUND
  Nonalcoholic Fatty Liver Disease (NAFLD) is common in postmenopausal women. It is associated with metabolic syndrome. However, the influence of hormone replacement therapy in NAFLD development in these women needs to be investigated. This study aimed to describe the clinical characteristics of NAFLD in postmenopausal women, and the relationship between hormone replacement therapy and this disease.
  
  
  METHODS
  From April 2009 to April 2011, 292 postmenopausal women from National Health System from Northeast of Brazil were selected, and 251 were included in this study. Menopause was defined as the absence of menstruation for 12 consecutive months in otherwise healthy women. Criteria to NAFLD included: presence of steatosis on abdominal ultrasound; history of alcohol consumption less than 20 g/day and exclusion of other liver diseases. All women underwent a clinical evaluation. Standard univariate and multivariate analyses were performed to evaluate the results.
  
  
  RESULTS
  The mean age was 56.5 ± 6.7 years. Hormone replacement therapy was referred by 21.1% (53) women and 78.9% (198) was not. Prevalence of NAFLD was 37.1% (93/251) in postmenopausal women, 26,4% (14/53) in the group with hormone replacement therapy and 39,9% (79/198) without hormone replacement therapy. Gamma-glutamyl transpeptidase (P = 0.001), alanine transaminase (P<0.01), ferritin (P<0.001) and insulin resistance (homeostatic model assessment of insulin resistance ≥3) (P<0.001) were higher in the group of women with NAFLD diagnosis who did not referred the use of hormone replacement therapy. Metabolic syndrome was also more frequent in women with NAFLD, who did not refer hormone replacement therapy.
  
  
  CONCLUSIONS
  In conclusion this data suggests elevated prevalence of NAFLD in postmenopausal women; negative association of hormone replacement therapy and NAFLD.
authors: Universidade Federal da Bahia, Faculdade de Medicina da Bahia, Programa de Medicina e Saúde.
authors: Gesira Soares de Assis
authors: GS
authors: Florentino
authors: Helma Pinchemel
authors: HP
authors: Cotrim
authors: Consuelo Padilha
authors: CP
authors: Vilar
authors: André Vinícius de Assis
authors: AV
authors: Florentino
authors: Geruza Maria Almeida
authors: GM
authors: Guimarães
authors: Victorino Spinelli Toscano
authors: VS
authors: Barreto
mesh_terms: D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005234:Fatty Liver / Q000209:etiology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000209:etiology; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D017698:Postmenopause / Q000187:drug effects*; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors