Bohdanowicz-Pawlak Anna, Lenarcik-Kabza Agnieszka, Brona Anna, Kuliczkowska-Płaksej Justyna, Łaczmański Łukasz, Zaleska-Dorobisz Urszula, Milewicz Andrzej
Department of Endocrinology, Diabetology and Isotope Therapy, Wrocław Medical University, Poland.
Endokrynol Pol. 2014;65(6):416-21. doi: 10.5603/EP.2014.0058.
The aim was to assess associations among PCOS and NAFLD, the lipoprotein lipase polymorphism gene, and metabolic disorders in PCOS.
In 184 women with PCOS and 125 healthy, premenopausal volunteers, sex steroids, lipids, glucose, insulin, aminotransferases, free androgen index (FAI), HOMA-IR and E2/T were calculated. Hepatic steatosis was determined by ultrasound. Whole genomic DNA was isolated from blood leucocytes. Lipoprotein lipase polymorphisms rs268 and rs328 were analysed by polymerase chain reaction (PCR) and minisequencing.
57.6% of PCOS women had NAFLD, while women without PCOS had NAFLD in 49.6%. PCOS-NAFLD women had higher BMI, WHR and waist circumference compared to women with PCOS without NAFLD and women without PCOS. PCOS-NAFLD women had lower SHBG, E2/T ratio, and higher FAI compared to other groups. ALT levels were higher in PCOS women with NAFLD compared to other groups. PCOS women with and without NAFLD had higher fasting glucose and insulin and HOMA compared to women without PCOS. Women with PCOS had higher triglycerides and lower HDL-C compared to women without PCOS. There was no evidence that evaluated polymorphisms influenced hepatic steatosis in women with and without PCOS.
PCOS is not an independent factor influencing NAFLD in women. The influences on NAFLD incidence in women are BMI > 25 kg/m², glucose level > 80 mg/dL, E2/T < 80 and ALT > 19 IU/L as independent factors. Hyperandrogenism in PCOS may increase the risk of NAFLD indirectly by obesity, insulin resistance, and directly by the hepatotoxic effect. Polymorphisms rs328 and rs268 of the lipoprotein lipase gene do not affect the occurrence of NAFLD in women with PCOS or without PCOS.
目的是评估多囊卵巢综合征（PCOS）与非酒精性脂肪性肝病（NAFLD）、脂蛋白脂肪酶多态性基因以及PCOS中的代谢紊乱之间的关联。
对184名PCOS女性和125名健康的绝经前志愿者，计算其性类固醇、脂质、葡萄糖、胰岛素、转氨酶、游离雄激素指数（FAI）、胰岛素抵抗指数（HOMA-IR）和雌二醇/睾酮比值（E2/T）。通过超声确定肝脂肪变性。从血液白细胞中分离全基因组DNA。通过聚合酶链反应（PCR）和微测序分析脂蛋白脂肪酶多态性rs268和rs328。
57.6%的PCOS女性患有NAFLD，而无PCOS的女性中NAFLD患病率为49.6%。与无NAFLD的PCOS女性和无PCOS的女性相比，PCOS合并NAFLD的女性BMI、腰臀比（WHR）和腰围更高。与其他组相比，PCOS合并NAFLD的女性性激素结合球蛋白（SHBG）、E2/T比值更低，FAI更高。与其他组相比，患有NAFLD的PCOS女性丙氨酸转氨酶（ALT）水平更高。与无PCOS的女性相比，有和无NAFLD的PCOS女性空腹血糖、胰岛素和HOMA更高。与无PCOS的女性相比，PCOS女性甘油三酯更高，高密度脂蛋白胆固醇（HDL-C）更低。没有证据表明所评估的多态性会影响有或无PCOS女性的肝脂肪变性。
PCOS不是影响女性NAFLD的独立因素。影响女性NAFLD发病率的独立因素为BMI>25kg/m²、血糖水平>80mg/dL、E2/T<80以及ALT>19IU/L。PCOS中的高雄激素血症可能通过肥胖、胰岛素抵抗间接增加NAFLD风险，也可能通过肝毒性作用直接增加风险。脂蛋白脂肪酶基因的rs328和rs268多态性不影响有或无PCOS女性NAFLD的发生。
