Gastroenterology and Hepatology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, Ohio, USA.
BMJ Open Gastroenterol. 2020 Aug;7(1). doi: 10.1136/bmjgast-2019-000352.
Polycystic ovarian syndrome (PCOS) is a common endocrine disorder in women. Women with PCOS have androgen excess as a defining feature. They also have increased insulin resistance and obesity, which are also risk factors for non-alcoholic fatty liver disease (NAFLD). However, published data regarding PCOS as independent risk factor for NAFLD remain controversial. Therefore, we conducted this study to evaluate the association between PCOS and NAFLD using a large national database.
We identified adult female patients (≥18 years) with PCOS using the National Inpatient Sample database between 2002 and 2014. The control group included patients who did not have a diagnosis of PCOS. Multivariate logistic regression analysis was performed to study the association of NAFLD with PCOS.
Out of a total of 50 785 354 women, 77 415 (0.15%) had PCOS. These patients were younger (32.7 vs 54.8; p<0.001) and more likely to be obese (29.4% vs 8.6%; p<0.001) compared with non-PCOS patients. However, the PCOS group had less hypertension (23.2% vs 39.8%), dyslipidaemia (12% vs 17.8%) and diabetes mellitus (18.1% vs 18.3%) (p<0.001 for all). Using multivariate logistic regression, patients with PCOS had significantly higher rate of NAFLD (OR 4.30, 95% CI 4.11 to 4.50, p<0.001).
Our study showed that patients with PCOS have four times higher risk of developing NAFLD compared with women without PCOS. Further studies are needed to assess if specific PCOS treatments can affect NAFLD progression.
多囊卵巢综合征（PCOS）是女性常见的内分泌疾病。PCOS 患者的特征是雄激素过多。她们还存在胰岛素抵抗和肥胖，这也是非酒精性脂肪性肝病（NAFLD）的危险因素。然而，关于 PCOS 作为 NAFLD 独立危险因素的已发表数据仍存在争议。因此，我们使用大型国家数据库进行了这项研究，以评估 PCOS 与 NAFLD 之间的关系。
我们使用 2002 年至 2014 年期间国家住院患者样本数据库确定患有 PCOS 的成年女性患者（≥18 岁）。对照组包括没有 PCOS 诊断的患者。采用多变量逻辑回归分析研究 NAFLD 与 PCOS 的关系。
在总共 50785354 名女性中，有 77415 名（0.15%）患有 PCOS。与非 PCOS 患者相比，这些患者年龄更小（32.7 岁 vs 54.8 岁；p<0.001），更有可能肥胖（29.4% vs 8.6%；p<0.001）。然而，PCOS 组的高血压（23.2% vs 39.8%）、血脂异常（12% vs 17.8%）和糖尿病（18.1% vs 18.3%）发生率较低（p<0.001）。使用多变量逻辑回归，患有 PCOS 的患者发生 NAFLD 的比率明显更高（OR 4.30，95%CI 4.11 至 4.50，p<0.001）。
我们的研究表明，与没有 PCOS 的女性相比，患有 PCOS 的患者发生 NAFLD 的风险高四倍。需要进一步研究评估特定的 PCOS 治疗是否会影响 NAFLD 的进展。
