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多囊卵巢综合征与超重具有等效可能性,是墨西哥人群中非酒精性脂肪性肝病发展和严重程度的一个危险因素。

Polycystic ovary syndrome with feasible equivalence to overweight as a risk factor for non-alcoholic fatty liver disease development and severity in Mexican population.

机构信息

Translational Research Unit, Medica Sur Clinical Foundation, Mexico City, Mexico.

Translational Research Unit, Obesity and Digestive Diseases Unit, Medica Sur Clinical Foundation, Mexico City, Mexico.

出版信息

Ann Hepatol. 2020 May-Jun;19(3):251-257. doi: 10.1016/j.aohep.2020.01.004. Epub 2020 Feb 5.

Abstract

INTRODUCTION AND OBJECTIVES

Polycystic ovary syndrome (PCOS) is the most common endocrinology disorder in women of reproductive age; these patients have a higher risk of suffering from non-alcoholic fatty liver disease (NAFLD). We determine the frequency of NAFLD in Mexican patients with PCOS and matched-controls.

PATIENTS AND METHODS

Cross-sectional study, with 98 women of 18-44 years old. Rotterdam 2003 criteria integrated PCOS diagnosis. Those with significant alcohol consumption, chronic liver disease, use of steatogenic drugs, and pharmacological PCOS treatment or fertility protocol were excluded. Controls were matched in a 1:1 ratio by age and body mass index (BMI). The presence of NAFLD was determined by transient elastography performed by a single experienced operator.

RESULTS

A total of 98 female volunteers at reproductive age were recruited. NAFLD denoted markedly higher in patients with than without PCOS at 69.3% vs. 34.6%, respectively. Compared to controls, PCOS patients had a significantly higher risk of NAFLD (OR=4.26, 95% CI 1.83-9.93). Severe steatosis was the most frequent NAFLD stage between women with PCOS and NAFLD. Patients with hyperandrogenism have a significantly higher mean CAP 277.83dB/m than controls without hyperandrogenism 191.57dB/m. NAFLD prevalence was 84.3% in PCOS patients with phenotype A, while in another phenotype, it was 41.1%.

CONCLUSIONS

PCOS is an independent risk factor for NAFLD development. NAFLD screening needs to be considered in all PCOS patients independently of BMI, except in PCOS patients without hyperandrogenism and BMI<25.

摘要

简介和目的

多囊卵巢综合征(PCOS)是育龄妇女中最常见的内分泌疾病;这些患者患非酒精性脂肪性肝病(NAFLD)的风险更高。我们确定了墨西哥多囊卵巢综合征患者和匹配对照者中 NAFLD 的频率。

患者和方法

这是一项横断面研究,纳入了 98 名 18-44 岁的女性。采用 2003 年鹿特丹标准综合诊断 PCOS。排除有大量饮酒、慢性肝病、使用致脂肪肝药物、药物治疗 PCOS 或生育方案的患者。对照组按年龄和体重指数(BMI) 1:1 匹配。通过一位经验丰富的操作人员进行的瞬时弹性成像来确定 NAFLD 的存在。

结果

共招募了 98 名处于生育期的女性志愿者。患有 PCOS 的患者中,NAFLD 的发生率明显高于无 PCOS 的患者,分别为 69.3%和 34.6%。与对照组相比,PCOS 患者患 NAFLD 的风险显著增加(OR=4.26,95%CI 1.83-9.93)。在患有 PCOS 和 NAFLD 的女性中,最常见的 NAFLD 阶段是严重脂肪变性。患有高雄激素血症的患者的平均 CAP 为 277.83dB/m,明显高于无高雄激素血症的对照组的 191.57dB/m。表型 A 的 PCOS 患者中,NAFLD 的患病率为 84.3%,而在另一种表型中,患病率为 41.1%。

结论

PCOS 是 NAFLD 发展的独立危险因素。除了无高雄激素血症和 BMI<25 的 PCOS 患者外,所有 PCOS 患者都需要考虑进行 NAFLD 筛查,而无需考虑 BMI。

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