title: The clinical characteristics and etiological study of nonalcoholic fatty liver disease in Chinese women with PCOS.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is highly associated with non-alcoholic fatty liver disease (NAFLD). There are extensive ethnic differences in the clinical manifestations, pathological changes, and ovarian changes in women with PCOS.
  
  
  OBJECTIVE
  To investigate the prevalence and clinical characteristics of NAFLD in Chinese women with PCOS.
  
  
  METHODS
  Non-pregnant women with PCOS (N= 602) and matched controls without PCOS (N=588) were recruited. Basal endocrine, oral glucose tolerance test, insulin release level, lipid level, blood pressure, and body mass index (BMI) were measured. Liver biochemical and B-hepatitis and C-hepatitis indices were determined.
  
  
  RESULTS
  NAFLD was significantly more prevalent in women with PCOS than controls (32.9% vs. 18.5%) and included 113 (57.1%) mild, 75 (37.8%) moderate and 10 (5.1%) severe cases. Luteinizing hormone was significantly lower in PCOS women with NAFLD than without NAFLD. In the PCOS group, NAFLD prevalence and severity increased with BMI. The liver index was significantly higher (p<0.001), and the quantitative insulin sensitivity check index and high density lipoprotein cholesterol were significantly lower (p<0.001) in the PCOS group than controls. Insulin resistance, abdominal obesity, diabetes mellitus, abnormal glucose tolerance, liver dysfunction, dyslipidemia, hypertension, and metabolic syndrome were significantly more prevalent in the NAFLD group than controls.
  
  
  CONCLUSIONS
  Chinese women with PCOS have a high prevalence of mostly mild and moderate NAFLD, not significantly associated with hyperandrogenism that increased significantly with BMI. Insulin resistance and metabolic abnormalities are important factors associated with NAFLD. Chinese women with BMI ≥24 kg/m(2) should be screened for NAFLD.
authors.affiliation: Division of Ultrasonography, Shandong Provincial Hospital, 324 Jingwu Road, Jinan, Shandong 250021, China.
authors.forename: Zhongyu
authors.initials: Z
authors.lastname: Qu
authors.affiliation: Medical Informatics Center, Peking University, 38 Xueyuan Road, Beijing 100191, China.
authors.forename: Yanhui
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Reproductive Medicine Center, Shandong University, 157 Jingliu Road, Jinan, Shandong 250021, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Reproductive Medicine Center, Shandong University, 157 Jingliu Road, Jinan, Shandong 250021, China.
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Reproductive Medicine Center, Shandong University, 157 Jingliu Road, Jinan, Shandong 250021, China.
authors.forename: Zijiang
authors.initials: Z
authors.lastname: Chen
keywords: Infertility; Nonalcoholic fatty liver disease.; Polycystic ovary syndrome