Polycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography

Abstract

Objective To evaluate the association between polycystic ovary syndrome (PCOS) and metabolic syndrome (MetS), adding liver assessment through elastography and ultrasound, for correlation with non-alcoholic fatty liver disease (NAFLD). Metabolic syndrome occurs in ∼ 43% of women with PCOS, and NAFLD is the hepatic expression of MetS. Methods One hundred women, 50 with PCOS and 50 controls, matched by age (18–35 years) and body mass index (BMI) were included, restricted to patients with overweight and obesity grade 1, at the Assis Chateaubrian Maternity School, Universidade Federal do Ceará, Brazil. For the diagnosis of PCOS, we adopted the Rotterdam criteria, and for the diagnosis of MetS, the criteria of the National Cholesterol Education Program (NCEP/ATP III). Hepatic elastography and ultrasound were performed to assess liver stiffness and echotexture, respectively. Results The average ages were 29.1 (±5.3) and 30.54 (±4.39) years, for the PCOS and the control group, respectively. Patients with PCOS had a risk 4 times higher of having MetS, odds ratio (95% confidence interval) = 4.14, than those in the control group. Women with PCOS had higher average of abdominal circumference (100.9 ± 9.08 cm vs 94.96 ± 6.99 cm) and triglycerides (162 ± 54.63 mg/dL vs 137.54 ± 36.91 mg/dL) and lower average of HDL cholesterol (45.66 ± 6.88 mg/dL vs 49.78 ± 7.05 mg/dL), with statistically significant difference. Hepatic steatosis was observed on ultrasound in women with PCOS; however, with no statistically significant difference. There was no change to NAFLD at elastography in any group. Conclusion Women with PCOS had 4-fold higher frequency of MetS and more hepatic steatosis, with no statistically significant difference. There was no change in liver stiffness between the groups at elastography. The results can be extended only to populations of overweight and obesity grade 1, with PCOS or not. They cannot be generalized to other untested groups.

Sonographic Association between Hepatic Steatosis Disease and Polycystic Ovarian Syndrome in Swabi Women

“…Corroborating our findings, Vassilatou et al observed a high prevalence of NAHSD in their cohort of 110 patients, with 64.7% of the women exhibiting this condition, suggesting a notable correlation between hepatic steatosis and PCOS. This association was further affirmed by Harsha et al, who identified a 38.3% prevalence rate of NAHSD among women with polycystic ovaries, linking it to elevated levels of cholesterol, insulin, and liver enzymes, with hyperandrogenism identified as a significant predictor (12)(13)(14)(15). Sarkar et al also reinforced the connection between PCOS and NAHSD, advocating for routine screening for hepatic steatosis in patients diagnosed with PCOS (16)(17)(18).…”

Fetal Metabolic Programming in the Etiology of Polycystic Ovarian Syndrome

“…(18,23) Obesity is present in 56% of patients with PCOS (10) and its presence can aggravate metabolic and reproductive disorders associated with it. (9) Studies have shown that patients with PCOS are 4 times more likely to have MS. (8,24) Thus, PCOS brings complex health consequences, in which it affects the quality of life of women in the short and long term. Its etiology is unclear and studies in the area are lacking.…”

Associations Between Sleep Quality and Metabolic Syndrome in a Brazilian Population: A Primary and Cross-Sectional Study

“…This condition includes hypertension, hyperglycemia (insulin resistance, IR) or diabetes, elevated triglycerides (TG) and decreased high-density lipoprotein cholesterol (HDL-c), and abdominal obesity. According to the International Diabetes Federation (IDF) guidelines, for the diagnosis of MetS, central obesity and any two of the above four additional cardiometabolic risk factors must be identified 3,5,6 .…”