Abdominal Obesity as a Predictive Factor of Nonalcoholic Fatty Liver Disease Assessed by Ultrasonography and Transient Elastography in Polycystic Ovary Syndrome and Healthy Women

Abstract

Polycystic ovary syndrome (PCOS) and nonalcoholic fatty liver (NAFLD) share similar clinical presentations including obesity, insulin resistance (IR), and metabolic abnormality. The predictive factors of NAFLD in women with PCOS and specifically in Asian women are not well established. Associated factors for NAFLD assessed by ultrasound (US) among a group of PCOS and healthy women were determined and diagnostic accuracy between US and transient elastography (TE) for NAFLD was compared and correlated. Sixty-three women with ages ranging from 20 to 40 years participated in the present cross-sectional study. Forty-two women with PCOS as diagnosed by the Rotterdam criteria and 21 healthy women were recruited into the study. Women with underlying hepatic diseases and history of alcohol consumption >20 g/day were excluded. Biochemical and hormonal testing, anthropometrics, liver US, and TE were assessed. Waist circumference (WC) greater than 80 cm was the only predictive factor for NAFLD as assessed by US in the whole group (adjusted odds ratio [aOR] 5.49, 95% confidence interval [CI]: 1.85–16.26, p <0.001). The value of the TE-based controlled attenuation parameter (CAP) was significantly correlated with stage of steatosis as assessed by US (correlation coefficient = 0.696, p <0.001). The diagnostic accuracies of dichotomized CAP ≥236 dB/m assessed for NAFLD using US as the gold standard were 84% and 78% sensitivity and specificity, respectively, with the area under the curve at 0.81 (p <0.001). Abdominal obesity, rather than the presence of PCOS, was shown to be the independently associated factor for NAFLD. WC could be used as the primary screening tool before performing complicated intervention for detection of steatosis. TE is an alternative noninvasive detection tool in women with PCOS for NAFLD and hepatic fibrosis identification.

Implication between Genetic Variants from APOA5 and ZPR1 and NAFLD Severity in Patients with Hypertriglyceridemia

“…This was a cross-sectional study of patients with HTG aimed at assessing the clinical, biochemical, and genetic factors related to moderate/severe NAFLD. As expected, the BMI, waist circumference, and insulin resistance were found to be related to NAFLD in this cohort, similar to the results of previous studies [ 23 , 24 , 25 ]. However, unlike other studies [ 26 ], TG levels were not significantly higher in patients with moderate/severe NAFLD compared with those with non/mild NAFLD, which may be because all the patients included in the study had HTG.…”

Non‐alcoholic fatty liver disease in premenopausal women with polycystic ovary syndrome: A systematic review and meta‐analysis

“…The allocation to either group was based on the following criteria: (i) the study explicitly stated that it investigated NAFLD in either lean or overweight/obese PCOS, 22,[33][34][35] (ii) there were data on either (or both) group(s) that allow us to calculate ORs for that subset of patients, 17,23,36 and (iii) studies in which PCOS and controls were matched for body weight and both groups had mean BMI <25 or >25 kg/m 2 were placed accordingly. [18][19][20][37][38][39][40][41][42][43] Using the above-mentioned BMI categories, further subanalyses investigating the presence of IR and the frequency of metabolic syndrome in each BMI subgroup was also conducted. Finally, we evaluated the effect of frequently reported cofactors on the desired outcome (NAFLD) through a meta-regression.…”

The Comparation of Anthropometric and Metabolic Indices in the Regulation and Prediction of Fatty Liver: a population-based cross-sectional study in China

“…Although in ammation contribute greatly to FL, abdominal obesity remains the main manifestations for FL. Compared with in ammatory changes existed in many diseases, WC have been shown in many studies to be directly related to fatty liver and to be more speci c for FL [40][41][42].…”