Division of Endocrinology and Metabolism, Department of Internal Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Division of Ultrasonography, Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Int J Obes (Lond). 2017 Sep;41(9):1341-1347. doi: 10.1038/ijo.2017.116. Epub 2017 May 10.
BACKGROUND/OBJECTIVE: Central obesity and insulin resistance (IR) are common conditions in women with polycystic ovary syndrome (PCOS) and in subjects with non-alcoholic fatty liver disease (NAFLD). However, few studies have addressed the association between hyperandrogenism (HA) and NAFLD. We aimed to determine whether variations in the free androgen index (FAI) might be associated with NAFLD prevalence.
SUBJECTS/METHODS: A cross-sectional study was performed including 400 Chinese women with PCOS and 100 age, and body mass index (BMI)-matched women. The anthropometric and serum biochemical parameters related to sex steroids, glucose and lipid profiles were examined. Liver fat content (LFC) was measured by quantitative ultrasound.
The prevalence of NAFLD was 56.23% in PCOS patients and 38% in controls (P=0.001), and this prevalence increased with FAI quartile independently of obesity and homeostasis model assessment of insulin resistance (HOMA-IR). The FAI level increased from non-NAFLD group to NAFLD group. The FAI was positively associated with the metabolic parameters LFC, BMI, waist circumference, alanine aminotransferases, aspartate, triglyceride, total cholesterol and low-density lipoprotein cholesterol, and was negatively associated with high-density lipoprotein. Moreover, in multivariate logistic regression analysis BMI, high-sensitivity C-reactive protein (hsCRP), FAI, LFC and HOMA-IR were significantly associated with NAFLD. The cut-off values of FAI, LFC, BMI and hsCRP to predict NAFLD were 9.86%, 17.19%, 24.38% and 0.72%, respectively. The area under the curve for predicting NAFLD in PCOS patients showed comparable sensitivity and specificity between BMI and a new index combining FAI with hsCRP.
A higher FAI level is associated with increased LFC and NAFLD prevalence independent of obesity and IR.
背景/目的：中心性肥胖和胰岛素抵抗（IR）在多囊卵巢综合征（PCOS）患者和非酒精性脂肪性肝病（NAFLD）患者中较为常见。然而，很少有研究探讨高雄激素血症（HA）与 NAFLD 之间的关系。我们旨在确定游离雄激素指数（FAI）的变化是否与 NAFLD 的患病率相关。
受试者/方法：进行了一项横断面研究，纳入了 400 名中国 PCOS 患者和 100 名年龄和体重指数（BMI）匹配的女性。检查了与性激素、血糖和血脂谱相关的人体测量学和血清生化参数。通过定量超声测量肝脏脂肪含量（LFC）。
PCOS 患者的 NAFLD 患病率为 56.23%，对照组为 38%（P=0.001），并且这种患病率随着 FAI 四分位数的增加而独立于肥胖和胰岛素抵抗稳态模型评估（HOMA-IR）增加。FAI 水平从非 NAFLD 组增加到 NAFLD 组。FAI 与代谢参数 LFC、BMI、腰围、丙氨酸氨基转移酶、天冬氨酸、甘油三酯、总胆固醇和低密度脂蛋白胆固醇呈正相关，与高密度脂蛋白呈负相关。此外，在多元逻辑回归分析中，BMI、高敏 C 反应蛋白（hsCRP）、FAI、LFC 和 HOMA-IR 与 NAFLD 显著相关。FAI、LFC、BMI 和 hsCRP 预测 NAFLD 的截断值分别为 9.86%、17.19%、24.38%和 0.72%。预测 PCOS 患者中 NAFLD 的曲线下面积显示 BMI 和将 FAI 与 hsCRP 相结合的新指数之间具有相当的敏感性和特异性。
较高的 FAI 水平与 LFC 增加和 NAFLD 患病率增加相关，与肥胖和 IR 无关。
