title: Adverse metabolic phenotype of adolescent girls with non-alcoholic fatty liver disease plus polycystic ovary syndrome compared with other girls and boys.
abstract: OBJECTIVE
  Non-alcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS) share risk associations of adiposity and insulin resistance. We examined the impact of a PCOS diagnosis on the metabolic phenotype of adolescent girls with NAFLD and compared this to girls without PCOS or NAFLD and to age-matched boys.
  
  
  METHODS
  Community-based adolescents from the Raine Cohort participated in assessments for NAFLD (572 girls and 592 boys) and PCOS (244 girls). One hundred and ninety-nine girls attended both assessments.
  
  
  RESULTS
  Amongst the 199 girls, PCOS was diagnosed in 16.1% and NAFLD in 18.6%. NAFLD was diagnosed in 10.1% of the boys. NAFLD was more prevalent in girls with PCOS than girls without PCOS (37.5% vs 15.1%, P = 0.003). Girls with NAFLD plus PCOS had greater adiposity (waist circumference, body mass index, suprailiac skinfold thickness [SST], serum androgens, high-sensitivity C-reactive protein, ferritin, homeostasis model assessment for insulin resistance (HOMA-IR), and lower serum sex hormone binding globulin levels than girls with NAFLD without a PCOS diagnosis (all P < 0.05). Girls with NAFLD plus PCOS had similar adiposity, HOMA-IR, and adiponectin levels to boys with NAFLD, but more adiposity, serum leptin and HOMA-IR than both girls and boys without NAFLD. PCOS (odds ratios 2.99, 95% confidence intervals 1.01-8.82, P = 0.048) and SST (odds ratios 1.14, 95% confidence intervals 1.08-1.20, P < 0.001) independently predicted NAFLD in adolescent girls, however, serum androgens and HOMA-IR levels did not.
  
  
  CONCLUSIONS
  Adolescent girls with NAFLD plus PCOS have a similar metabolic phenotype to boys with NAFLD. Increasing SST and pre-existing PCOS independently predict NAFLD in adolescent girls.
authors.affiliation: School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia.|Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Perth, Western Australia, Australia.|Department of Gastroenterology, Fremantle Hospital, Fremantle, Western Australia, Australia.|Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
authors.forename: Oyekoya T
authors.initials: OT
authors.lastname: Ayonrinde
authors.affiliation: School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia.|Liver Transplantation Unit, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
authors.forename: Leon A
authors.initials: LA
authors.lastname: Adams
authors.affiliation: School of Women's and Infants' Health, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Dorota A
authors.initials: DA
authors.lastname: Doherty
authors.affiliation: School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Trevor A
authors.initials: TA
authors.lastname: Mori
authors.affiliation: School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Beilin
authors.affiliation: Centre for Child Health Research, Telethon Institute for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Wendy H
authors.initials: WH
authors.lastname: Oddy
authors.affiliation: Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia.|The Royal Women's Hospital, Melbourne, Victoria, Australia.
authors.forename: Martha
authors.initials: M
authors.lastname: Hickey
authors.affiliation: Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Sloboda
authors.affiliation: Department of Gastroenterology and Hepatology, Fiona Stanley Hospital, Perth, Western Australia, Australia.|Department of Gastroenterology, Fremantle Hospital, Fremantle, Western Australia, Australia.|Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.|Murdoch University, Perth, Western Australia, Australia.
authors.forename: John K
authors.initials: JK
authors.lastname: Olynyk
authors.affiliation: School of Women's and Infants' Health, The University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Roger
authors.initials: R
authors.lastname: Hart
mesh_terms: D050154:Adiposity; D000293:Adolescent; D017677:Age Distribution; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D016017:Odds Ratio; D010641:Phenotype; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D012885:Skinfold Thickness; D014904:Western Australia / Q000453:epidemiology
chemical_list: D015415:Biomarkers
keywords: C-reactive protein; Raine study; community; insulin resistance; non-alcoholic fatty liver disease; obesity; polycystic ovary syndrome; testosterone