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.
Aliment Pharmacol Ther. 2017 Jun;45(11):1403-1412. doi: 10.1111/apt.14058. Epub 2017 Mar 30.
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.
非酒精性脂肪性肝病（NAFLD）已知与多囊卵巢综合征（PCOS）有关。然而，大多数研究都调查了肥胖 PCOS 患者中 NAFLD 的患病率。
比较有或无 PCOS 的女性中非肥胖型 NAFLD 的患病率，并在非肥胖亚洲队列中评估 PCOS 与 NAFLD 之间的独立相关性。
这是一项使用前瞻性 PCOS 队列的病例对照研究。排除其他潜在慢性肝病病因后，共纳入 275 例非肥胖型 PCOS 患者和 892 例非肥胖型对照者。通过肝脏超声检查确定 NAFLD。主要结局是非肥胖型 PCOS 女性与非肥胖型对照者之间的超声检查 NAFLD 患病率，以及非肥胖型 NAFLD 与 PCOS 之间的独立相关性。
非肥胖型 PCOS 女性的 NAFLD 患病率明显高于非肥胖型对照者（5.5%比 2.8%，P=0.027）。校正年龄和体重指数（BMI）后，PCOS 与非肥胖型 NAFLD 相关（比值比：2.62，95%置信区间：1.25-5.48）。在 PCOS 女性中，经年龄、BMI、血脂谱、胰岛素抵抗或血糖状态校正后，游离睾酮或游离雄激素指数所代表的雄激素水平与 NAFLD 相关。
与无 PCOS 者相比，患有 PCOS 的女性中非肥胖型 NAFLD 更为普遍。在非肥胖型 PCOS 患者中，高雄激素血症可能是非肥胖型 NAFLD 的独立危险因素。
