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.
Eur J Endocrinol. 2015 Dec;173(6):739-47. doi: 10.1530/EJE-15-0567. Epub 2015 Sep 4.
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.
Prospective, observational, and cross-sectional study.
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.
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.
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.
关于非酒精性脂肪性肝病（NAFLD）的绝经前妇女中多囊卵巢综合征（PCOS）的存在，目前的数据有限。我们旨在研究超重和肥胖的绝经前妇女中，NAFLD 患者中 PCOS 的患病率。
前瞻性、观察性和横断面研究。
我们研究了 110 名年龄在 18-45 岁之间的、因腹部超声检查发现非酒精性脂肪肝（排除继发性肝病的病因）而报告无或极少饮酒的、体质量指数（BMI）为 25.1-49.1kg/m2的、看似健康的超重和肥胖（BMI：25.1-49.1kg/m2）的绝经前妇女（BMI：25.1-49.1kg/m2），并对其进行了临床检查、生化评估和盆腔超声检查，以符合 PCOS（鹿特丹标准）的诊断。胰岛素抵抗（IR）采用稳态模型评估的胰岛素抵抗指数（HOMA-IR）评估，计算游离雄激素指数。
在 110 名妇女中，71 名（64.5%）患有 NAFLD。与无 NAFLD 的妇女相比，患有 NAFLD 的妇女更常被诊断为 PCOS（分别为 43.7%和 23.1%，P=0.04）、代谢综合征（分别为 30.2%和 5.3%，P=0.003）和异常血脂谱（分别为 81.1%和 51.3%，P=0.002）。所有患有葡萄糖代谢异常的妇女均患有 NAFLD（P=0.01）。尽管 PCOS 与 NAFLD 相关（比值比 2.6，95%置信区间：1.1-6.2，P=0.04），但在调整年龄、BMI 和腰臀比后，较高的 HOMA-IR 值（比值比 2.2，95%置信区间：1.1-4.4，P=0.02）和甘油三酯水平（比值比 1.01，95%置信区间：1.00-1.02，P=0.04）独立预测了 NAFLD。
这些发现表明，在超重和肥胖的绝经前妇女中，NAFLD 患者中 PCOS 的患病率较高，尽管不能支持该综合征主要涉及 NAFLD。可能需要对这些妇女进行 PCOS 的评估。
