控制衰减参数评估肥胖多囊卵巢综合征患者的肝脂肪变性。
Controlled attenuation parameters to assess liver steatosis in obese patients with polycystic ovary syndrome.
机构信息
Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Endocrinology, Shengjing Hospital of China Medical University, Shenyang, China.
出版信息
Front Endocrinol (Lausanne). 2023 Aug 31;14:1241734. doi: 10.3389/fendo.2023.1241734. eCollection 2023.
OBJECTIVES
This study was performed to investigate the changes and influencing factors of liver controlled attenuation parameter (CAP) in obese patients with polycystic ovary syndrome (PCOS), and to determine the prevalence and risk factors of nonalcoholic fatty liver disease (NAFLD) in PCOS patients with obesity.
METHODS
Forty-one PCOS patients with obesity and twenty age- and body mass index (BMI)-matched control women without PCOS were enrolled in this study. General data, body composition, biochemical parameters, sex hormones, and liver CAP in the two groups were collected and compared. Liver CAP was measured using transient elastography.
RESULTS
NAFLD was more common in the Obese PCOS group than in the control group (75.61% vs. 45.00%, =0.018). Compared to the control group, the obese PCOS group showed apparent increases in alanine transaminase (ALT), aspartate transaminase (AST), CAP, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), totle testosterone (TT), free androgen index (FAI), fasting insulin (FIns), and homeostasis model assessment-insulin resistance (HOMA-IR), along with lower high-density lipoprotein cholesterol (HDL-C) and sex hormone binding globulin (SHBG) levels. In addition, as shown by Spearman analysis, liver CAP in PCOS patients with obesity had a positive correlation with ALT, AST, TG, TT, FAI, FIns, and HOMA-IR, and a negative correlation with SHBG. Logistic regression analysis showed that TG, TT, FIns, and HOMA-IR were risk factors for NAFLD, while TT was an independent risk factor for NAFLD in PCOS patients with obesity.
CONCLUSION
PCOS patients with obesity had a significantly higher prevalence of NAFLD. Furthermore, in PCOS patients with obesity, liver CAP was associated with disorders of lipid metabolism, insulin resistance, and hyperandrogenemia, with elevated testosterone levels being an independent risk factor for NAFLD in PCOS patients with obesity.
目的
本研究旨在探讨肥胖多囊卵巢综合征（PCOS）患者肝控制衰减参数（CAP）的变化及其影响因素，并确定肥胖 PCOS 患者中非酒精性脂肪性肝病（NAFLD）的患病率和危险因素。
方法
本研究纳入了 41 例肥胖 PCOS 患者和 20 例年龄和体重指数（BMI）匹配的非 PCOS 对照组女性。收集并比较两组患者的一般资料、人体成分、生化指标、性激素和肝脏 CAP。采用瞬时弹性成像技术测量肝脏 CAP。
结果
肥胖 PCOS 组的 NAFLD 患病率高于对照组（75.61% vs. 45.00%，=0.018）。与对照组相比，肥胖 PCOS 组的丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、CAP、甘油三酯（TG）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、总睾酮（TT）、游离雄激素指数（FAI）、空腹胰岛素（FIns）和稳态模型评估-胰岛素抵抗指数（HOMA-IR）明显升高，而高密度脂蛋白胆固醇（HDL-C）和性激素结合球蛋白（SHBG）水平则明显降低。Spearman 分析结果显示，肥胖 PCOS 患者的肝脏 CAP 与 ALT、AST、TG、TT、FAI、FIns 和 HOMA-IR 呈正相关，与 SHBG 呈负相关。Logistic 回归分析显示，TG、TT、FIns 和 HOMA-IR 是 NAFLD 的危险因素，而 TT 是肥胖 PCOS 患者中 NAFLD 的独立危险因素。
结论
肥胖 PCOS 患者的 NAFLD 患病率明显更高。此外，在肥胖 PCOS 患者中，肝脏 CAP 与脂代谢紊乱、胰岛素抵抗和高雄激素血症有关，升高的睾酮水平是肥胖 PCOS 患者中 NAFLD 的独立危险因素。
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