多囊卵巢综合征的表型与代谢功能障碍相关脂肪性肝病之间的关联。
The association between phenotypes of polycystic ovary syndrome and metabolic dysfunction-associated fatty liver disease.
作者信息
Hong So-Hyeon, Sung Yeon-Ah, Hong Young Sun, Song Do Kyeong, Jung Hyein, Jeong Kyungah, Chung Hyewon, Lee Hyejin
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
出版信息
Front Endocrinol (Lausanne). 2025 Aug 4;16:1480528. doi: 10.3389/fendo.2025.1480528. eCollection 2025.
INTRODUCTION
Polycystic ovary syndrome (PCOS) is associated with an increased risk of non-alcoholic fatty liver disease (NAFLD). With the introduction of the new definition of metabolic dysfunction-associated fatty liver disease (MAFLD), there has been a lack of studies investigating the prevalence and clinical characteristics of PCOS and its phenotypes, including hyperandrogenism (HA), oligoanovulation (OA), and polycystic ovarian morphology (PCO) in association with MAFLD. The aim of this study is to explore MAFLD prevalence in young women with PCOS and determine the independent impact of PCOS phenotypes on MAFLD.
METHODS
This cross-sectional study included 1,422 women with PCOS diagnosed using the Rotterdam criteria, the presence of at least two of three diagnostic criteria: 1) hyperandrogenism (HA), 2) oligoanovulation (OA), and 3) polycystic ovary morphology (PCO).
RESULTS
Among women with PCOS, 31.2% had NAFLD, and 65.1% of them were diagnosed with MAFLD. In PCOS phenotypes, MAFLD prevalence was 25.1% for HA+OA+PCO, 27.6% for HA+OA, 8.8% for HA+PCO, and 13.0% for OA+PCO. Women with PCOS and HA+OA+PCO had higher odds of MAFLD (OR [95% CI] of 1.47 [1.04-2.09]), as did those with HA+OA (1.87 [1.18-2.96]), after adjusting for demographic and clinical factors. However, the association between women with PCOS and HA+PCO and MAFLD was not statistically significant (0.51 [0.21-1.24]).
DISCUSSION
In women with PCOS, both HA+OA+PCO and HA+OA phenotypes were independently associated with MAFLD. HA and OA may contribute independently to the higher prevalence of MAFLD in these individuals.
引言
多囊卵巢综合征（PCOS）与非酒精性脂肪性肝病（NAFLD）风险增加相关。随着代谢功能障碍相关脂肪性肝病（MAFLD）新定义的引入，缺乏关于PCOS及其表型（包括高雄激素血症（HA）、排卵稀少（OA）和多囊卵巢形态（PCO））与MAFLD相关的患病率及临床特征的研究。本研究旨在探讨PCOS年轻女性中MAFLD的患病率，并确定PCOS表型对MAFLD的独立影响。
方法
本横断面研究纳入了1422例根据鹿特丹标准诊断为PCOS的女性，存在以下三项诊断标准中的至少两项：1）高雄激素血症（HA），2）排卵稀少（OA），3）多囊卵巢形态（PCO）。
结果
在PCOS女性中，31.2%患有NAFLD，其中65.1%被诊断为MAFLD。在PCOS表型中，HA+OA+PCO的MAFLD患病率为25.1%，HA+OA为27.6%，HA+PCO为8.8%，OA+PCO为13.0%。在调整人口统计学和临床因素后，患有PCOS且HA+OA+PCO的女性发生MAFLD的几率更高（OR [95% CI]为1.47 [1.04 - 2.09]），HA+OA的女性也是如此（1.87 [1.18 - 2.96]）。然而，患有PCOS且HA+PCO的女性与MAFLD之间的关联无统计学意义（0.51 [0.21 - 1.24]）。
讨论
在PCOS女性中，HA+OA+PCO和HA+OA表型均与MAFLD独立相关。HA和OA可能分别导致这些个体中MAFLD的较高患病率。
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