title: Polycystic ovary syndrome with hyperandrogenism as a risk factor for non-obese non-alcoholic fatty liver disease.
abstract: Non-alcoholic fatty liver disease (NAFLD) is known to be associated with polycystic ovary syndrome (PCOS). However, most studies investigated the prevalence of NAFLD in obese PCOS patients.
  
  
  
  To compare the prevalence of non-obese NAFLD in women with or without PCOS, and to assess an independent association between PCOS and NAFLD in a non-obese Asian cohort.
  
  
  
  This was a case-control study using a prospective PCOS cohort. After subjects with other potential causes of chronic liver disease were excluded, 275 non-obese women with PCOS and 892 non-obese controls were enrolled. NAFLD was determined by hepatic ultrasonography. Main outcomes were the prevalence of NAFLD on hepatic ultrasonography between non-obese women with or without PCOS, and an independent association between non-obese NAFLD and PCOS.
  
  
  
  Non-obese women with PCOS had a significantly higher prevalence of NAFLD than those without PCOS (5.5% vs. 2.8%, P = 0.027). PCOS was associated with non-obese NAFLD (odds ratio: 2.62, 95% confidence intervals: 1.25-5.48) after adjustment for age and body mass index (BMI). In women with PCOS, the level of androgenicity represented by free testosterone or free androgen index was associated with NAFLD after adjustment for age, BMI, lipid profile, insulin resistance or glycaemic status.
  
  
  
  Non-obese NAFLD is more prevalent in women with polycystic ovary syndrome than in those without. In non-obese patients with polycystic ovary syndrome, hyperandrogenemia may be an independent risk factor for non-obese NAFLD.
authors.affiliation: Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.|The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: J J
authors.initials: JJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.|Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
authors.forename: D
authors.identifier: 0000-0003-1919-6800
authors.initials: D
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: J Y
authors.initials: JY
authors.lastname: Yim
authors.affiliation: Department of Radiology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Kang
authors.affiliation: Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: K H
authors.initials: KH
authors.lastname: Han
authors.affiliation: Department of Obstetrics and Gynecology, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Korea.
authors.forename: S M
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, Seoul Municipal Boramae Hospital, Seoul, Korea.
authors.forename: K R
authors.initials: KR
authors.lastname: Hwang
authors.affiliation: The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.|Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: S Y
authors.initials: SY
authors.lastname: Ku
authors.affiliation: The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.|Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: C S
authors.initials: CS
authors.lastname: Suh
authors.affiliation: The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.|Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Kim
authors.affiliation: The Institute of Reproductive Medicine and Population, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.|Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Y M
authors.initials: YM
authors.lastname: Choi
mesh_terms: D000328:Adult; D000728:Androgens / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology*; D007333:Insulin Resistance; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology* / Q000209:etiology; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000728:Androgens