Non-alcoholic fatty liver disease in women with polycystic ovary syndrome: assessment of non-invasive indices predicting hepatic steatosis and fibrosis.
OBJECTIVE
Insulin resistance contributes to the pathogenesis of both polycystic ovary syndrome (PCOS) and non-alcoholic fatty liver disease (NAFLD). The main aim of the present study was the evaluation of non-invasive indices of hepatic steatosis and fibrosis in PCOS women with or without metabolic syndrome (MetS).


METHODS
In this cross-sectional study, three non-invasive indices for hepatic steatosis [NAFLD liver fat score, lipid accumulation product (LAP) and hepatic steatosis index (HIS)] and four for fibrosis [FIB-4, aspartate aminotransferase (AST)-to-Platelet Ratio Index (APRI), body mass index (BMI)-Age-Alanine aminotransferase (ALT)-Triglycerides (BAAT) and BMI AST/ALT Ratio Diabetes (BARD)] were calculated in 314 PCOS women (77 with, 237 without MetS) and 78 controls.


RESULTS
All steatosis indices were significantly higher in the PCOS than the control group (NAFLD liver fat score: -0.139 ± 0.117 vs. -0.976 ± 0.159, p<0.001; LAP: 43.3 ± 1.9 vs. 34.7 ± 3.1, p=0.036; HIS: 44.6 ± 0.5 vs. 42.1 ± 0.8, p=0.016). FIB-4 and BAAT [fibrosis stage (F)2-4] were higher in the PCOS group (0.480 ± 0.020 vs. 0.400 ± 0.013, p<0.001; and 15.6% vs. 5.1%, respectively), whereas APRI and BARD were not. All steatosis indices were significantly higher in PCOS women with than without MetS (NAFLD liver fat score: 1.874 ± 0.258 vs. -0.793 ± 0.099, p<0.001; LAP: 76.8 ± 4.9 vs. 33.4 ± 1.4, p<0.001; and HIS: 49.8 ± 1 vs. 43 ± 0.5, p<0.001). Of the fibrosis indices, only BAAT (F2-4: 50.6% vs. 4.2%) was higher in PCOS women with MetS.


CONCLUSIONS
Non-invasive indices of hepatic steatosis were significantly higher in PCOS, especially in the presence of MetS, whereas indices of hepatic fibrosis yielded controversial results. Further studies are warranted to evaluate the long-term outcomes of hepatic steatosis and fibrosis indices in PCOS women.
Stergios A
SA
Polyzos
Dimitrios G
DG
Goulis
Jannis
J
Kountouras
Gesthimani
G
Mintziori
Panagiotis
P
Chatzis
Efstathios
E
Papadakis
Ilias
I
Katsikis
Dimitrios
D
Panidis
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis*; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D011085:Polycystic Ovary Syndrome / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood
D014280:Triglycerides; D000410:Alanine Transaminase