Increased prevalence of polycystic ovary syndrome in premenopausal women with nonalcoholic fatty liver disease.
OBJECTIVE
Limited data exist concerning the presence of polycystic ovary syndrome (PCOS) in premenopausal women with nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prevalence of PCOS in overweight and obese premenopausal women with NAFLD.


METHODS
Prospective, observational, and cross-sectional study.


METHODS
We studied 110 apparently healthy, overweight, and obese (BMI: 25.1-49.1 kg/m(2)) premenopausal women (age: 18-45 years) reporting no or minimal alcohol consumption for NAFLD with abdominal ultrasonography after excluding causes of secondary liver disease and for PCOS (Rotterdam criteria) with clinical examination, biochemical evaluation, and pelvic ultrasonography. Insulin resistance (IR) was assessed by homeostasis model assessment of IR (HOMA-IR), and free androgen index was calculated.


RESULTS
NAFLD was detected in 71/110 women (64.5%). Women with NAFLD compared to women without NAFLD were more commonly diagnosed with PCOS (43.7% vs 23.1%, respectively, P=0.04), metabolic syndrome (30.2% vs 5.3%, respectively, P=0.003), and abnormal lipid profile (81.1% vs 51.3%, P=0.002). All women with abnormal glucose metabolism had NAFLD (P=0.01). Although PCOS was associated with NAFLD (OR 2.6, 95% CI: 1.1-6.2, P=0.04), in a multivariate analysis higher HOMA-IR values (OR 2.2, 95% CI: 1.1-4.4, P=0.02) and triglyceride levels (OR 1.01, 95% CI: 1.00-1.02, P=0.04) independently predicted NAFLD, after adjusting for age, BMI, and waist-to-hip ratio.


CONCLUSIONS
These findings indicate an increased prevalence of PCOS in overweight and obese premenopausal women with NAFLD, although it is not supported that the syndrome is primarily involved in NAFLD. Evaluation for PCOS may be considered in these women.
Endocrine Unit2nd Department of Internal Medicine, Propaedeutic and Research Center3rd Department of Obstetrics and Gynecology2nd Department of Radiology2nd Department of Internal MedicineResearch Center, Athens University Medical School, 'Attikon' University Hospital, 1 Rimini Street, Haidari, Athens 12462, Greece evassilatou@gmail.com.
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Vassilatou
Endocrine Unit2nd Department of Internal Medicine, Propaedeutic and Research Center3rd Department of Obstetrics and Gynecology2nd Department of Radiology2nd Department of Internal MedicineResearch Center, Athens University Medical School, 'Attikon' University Hospital, 1 Rimini Street, Haidari, Athens 12462, Greece.
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Vassiliadi
Endocrine Unit2nd Department of Internal Medicine, Propaedeutic and Research Center3rd Department of Obstetrics and Gynecology2nd Department of Radiology2nd Department of Internal MedicineResearch Center, Athens University Medical School, 'Attikon' University Hospital, 1 Rimini Street, Haidari, Athens 12462, Greece.
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Salambasis
Endocrine Unit2nd Department of Internal Medicine, Propaedeutic and Research Center3rd Department of Obstetrics and Gynecology2nd Department of Radiology2nd Department of Internal MedicineResearch Center, Athens University Medical School, 'Attikon' University Hospital, 1 Rimini Street, Haidari, Athens 12462, Greece.
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Lazaridou
Endocrine Unit2nd Department of Internal Medicine, Propaedeutic and Research Center3rd Department of Obstetrics and Gynecology2nd Department of Radiology2nd Department of Internal MedicineResearch Center, Athens University Medical School, 'Attikon' University Hospital, 1 Rimini Street, Haidari, Athens 12462, Greece.
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Koutsomitopoulos
Endocrine Unit2nd Department of Internal Medicine, Propaedeutic and Research Center3rd Department of Obstetrics and Gynecology2nd Department of Radiology2nd Department of Internal MedicineResearch Center, Athens University Medical School, 'Attikon' University Hospital, 1 Rimini Street, Haidari, Athens 12462, Greece.
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Kelekis
Endocrine Unit2nd Department of Internal Medicine, Propaedeutic and Research Center3rd Department of Obstetrics and Gynecology2nd Department of Radiology2nd Department of Internal MedicineResearch Center, Athens University Medical School, 'Attikon' University Hospital, 1 Rimini Street, Haidari, Athens 12462, Greece.
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Kassanos
Endocrine Unit2nd Department of Internal Medicine, Propaedeutic and Research Center3rd Department of Obstetrics and Gynecology2nd Department of Radiology2nd Department of Internal MedicineResearch Center, Athens University Medical School, 'Attikon' University Hospital, 1 Rimini Street, Haidari, Athens 12462, Greece Endocrine Unit2nd Department of Internal Medicine, Propaedeutic and Research Center3rd Department of Obstetrics and Gynecology2nd Department of Radiology2nd Department of Internal MedicineResearch Center, Athens University Medical School, 'Attikon' University Hospital, 1 Rimini Street, Haidari, Athens 12462, Greece.
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Hadjidakis
Endocrine Unit2nd Department of Internal Medicine, Propaedeutic and Research Center3rd Department of Obstetrics and Gynecology2nd Department of Radiology2nd Department of Internal MedicineResearch Center, Athens University Medical School, 'Attikon' University Hospital, 1 Rimini Street, Haidari, Athens 12462, Greece.
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Dimitriadis
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology*; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology*; D017697:Premenopause; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult