Analyses of risk factors for polycystic ovary syndrome complicated with non-alcoholic fatty liver disease

Zhang, Jianhai; Hu, Jian; Zhang, Chunxia; Yang, Jiao; Kong, Xiang; Wang, Wei

doi:10.3892/etm.2018.5932

Cited by 27 publications

(31 citation statements)

References 23 publications

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“…In patients with NAFLd, triglyceride (TG) synthesis was identified to be increased compared with that of the TG export from the liver cells (10). Liver free fatty acids (FFAs) that are derived from circulating non-esterified fatty acids (NEFAs) are stored as TGs.…”

Section: Introductionmentioning

confidence: 99%

CYP4A11 is involved in the development of nonalcoholic fatty liver disease via ROS‑induced lipid peroxidation and inflammation

et al. 2020

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Nonalcoholic fatty liver disease (NAFLd) is a fat metabolism disorder that occurs in liver cells. The development of NAFLd is considered to be associated with hepatic oxidative stress. The present study aimed to investigate the role of cytochrome P450 4A11 (cYP4A11) in the pathogenesis of NAFLd. The levels of plasma cYP4A11 and lipid peroxidation products levels exhibited a high correlation, and were increased significantly compared with those from normal subjects. Further in vitro studies demonstrated that the expression levels of cYP4A11 and the content of reactive oxygen species (ROS) were increased in free fatty acid (FFA)-stimulated HepG2 cells. Clofibrate, a CYP4A11 inducer, aggravated cell damage. Opposite results were observed for the cYP4A11 inhibitor HET0016, which attenuated apoptosis in FFA-treated cells. Furthermore, cYP4A11 gene overexpression and silencing were used to investigate the effects on inflammatory cytokine secretion. The data demonstrated that cYP4A11 promoted an increase in the mRNA expression of tumor necrosis factor α, interleukin (IL)-1β and IL-6 in response to FFA. In addition, western blot analysis highlighted that cYP4A11 caused an upregulation of phosphorylated p65 levels and therefore affected the NF-κB signaling pathway. The data demonstrated that cYP4A11 may metabolize fatty acids to promote the production of ROS and accelerate the progression of NAFLd.

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Section: Introductionmentioning

confidence: 99%

CYP4A11 is involved in the development of nonalcoholic fatty liver disease via ROS‑induced lipid peroxidation and inflammation

et al. 2020

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“…Numerous publications have proposed that low levels of SHBG are strongly associated with the features of metabolic syndrome [ 11 – 13 ] and may play an important role in modifying the risk of insulin resistance and its outcomes [ 14 – 16 ]. An inverse association between SHBG and the risk of NAFLD was observed in diabetic patients and women with polycystic ovarian syndrome [ 17 – 20 ]. Wang N et al also demonstrated that lower levels of SHBG were associated with the presence of NAFLD in Chinese men and menopausal women [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Association of sex hormone-binding globulin with nonalcoholic fatty liver disease in Chinese adults

et al. 2018

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BackgroundSex hormone-binding globulin (SHBG), a glycoprotein synthesized by hepatocytes, has been linked to insulin resistance and hepatic lipid metabolism and is suggested to be associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the association of SHBG with NAFLD in Chinese adults.MethodsWe conducted a community-based, cross-sectional study in China involving 2912 participants aged 40–75 years old. All participants underwent detection for hepatic fat infiltration by ultrasound in addition to providing complete medical history and undergoing physical and blood biochemical examinations. The association of serum SHBG with the presence of NAFLD was reported by adjusted odds ratio after applying logistic regression models. To further explore the relationship between SHBG and NAFLD, mRNA expression of SHBG and hepatocyte nuclear factor 4-α (HNF4α), as well as intrahepatic triglycerides, were determined from the liver tissues of 32 subjects with different degrees of steatosis.ResultsSerum SHBG levels in patients with NAFLD (median, 43.8 nmol/L; interquartile range, 33.4–56.8 nmol/L) were significantly lower than those in non-NAFLD subjects (median, 63.4 nmol/L; interquartile range, 47.6–83.1 nmol/L). Serum SHBG levels were inversely correlated with WHR, trunk fat percentage, glucose, HOMA-IR, TG, UA and DHEAS, and were positively correlated with HDL-C levels (all p < 0.001). Logistic regression analysis indicated that serum SHBG levels were negatively associated with the presence of NAFLD in all subjects, as well as the subgroups stratified by sex, BMI and HOMA-IR (all p < 0.05). In human liver tissues, SHBG and HNF4α mRNA expression decreased along with the elevated grade of hepatic steatosis. Both SHBG and HNF4α mRNA expression levels were negatively correlated with intrahepatic triglycerides.ConclusionsThese results demonstrate that SHBG levels were negatively associated with the presence of NAFLD in middle-aged and elderly Chinese adults.Electronic supplementary materialThe online version of this article (10.1186/s12986-018-0313-8) contains supplementary material, which is available to authorized users.

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“…BMI was significantly different (P < 0.01), and blood glucose showed a tendency to be different (P = 0.07) between the two groups. BMI, blood glucose, and testosterone are related to fatty liver [ 10 , 11 , 25 ]. Therefore, we set up two models for predicting elevated liver enzymes using receiver-operating characteristics (ROC) curves to determine clinical references for early diagnosis and prevention.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, the identification of risk factors for NAFLD in PCOS is required to provide clinical references for early diagnosis and prevention. Several clinical measurements, such as age, body mass index (BMI), waist-to-hip ratio, obesity, triglyceride level, homeostatic model assessment for insulin resistance (HOMA-IR) index, and androgen level, are considered to be associated with NAFLD in women with PCOS [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Risk Factors of Elevated Liver Enzymes in Japanese Women With Polycystic Ovary Syndrome

et al. 2018

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BackgroundPolycystic ovary syndrome (PCOS) is a common endocrine disorder among reproductive-aged women. While PCOS is associated with an increased risk of obesity and insulin resistance, little is known regarding the prevalence of and risk factors for nonalcoholic fatty liver disease (NAFLD) among Japanese women with PCOS. We estimated the prevalence of and risk factors for elevated liver enzymes, as the index of NAFLD, in Japanese women with PCOS.MethodsWe retrospectively reviewed 102 reproductive-aged women who visited the Department of Gynecology, Kyoto Medical Center in Japan from January 2000 to September 2016. Inclusion criterion was confirmed diagnosis of PCOS using International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10) codes. Exclusion criteria were women with a history of liver diseases, missing body mass index (BMI) and serum alanine aminotransferase (ALT) data, and pregnancy. Data regarding age; BMI; and levels of blood glucose, serum lipid, liver enzymes, and sex hormones were obtained from medical records. Elevated liver enzymes was defined as ALT > 19 IU/L. Optimal cutoffs for risk factors for elevated liver enzymes were calculated to determine predictors of elevated liver enzymes using area under the curve (AUC) by receiver-operating characteristics (ROC).ResultsThe prevalence of elevated liver enzymes was 33.3%. BMI was significantly higher in PCOS patients than in those without elevated liver enzymes (25.3 vs. 20.7 kg/m2, P < 0.05). ROC analyses were performed using BMI and blood glucose and testosterone levels because BMI and blood glucose showed differences between the groups and testosterone is related to fatty liver. AUC of the model including BMI and blood glucose and testosterone levels was 0.861 (sensitivity, 66.7%; specificity, 100%).ConclusionsThese findings suggest that elevated liver enzymes are common in women with PCOS. An algorism using BMI and blood glucose and testosterone levels might be useful to determine elevated liver enzymes in women with PCOS. Our finding may be useful for the study of NAFLD among Japanese women with PCOS since several previous studies have indicated elevated liver enzymes to be related to the potential presence of NAFLD. Further examination, including abdominal ultrasonography and/or liver biopsy data, is required to confirm these results.

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Analyses of risk factors for polycystic ovary syndrome complicated with non-alcoholic fatty liver disease

Cited by 27 publications

References 23 publications

CYP4A11 is involved in the development of nonalcoholic fatty liver disease via ROS‑induced lipid peroxidation and inflammation

CYP4A11 is involved in the development of nonalcoholic fatty liver disease via ROS‑induced lipid peroxidation and inflammation

Association of sex hormone-binding globulin with nonalcoholic fatty liver disease in Chinese adults

Prevalence and Risk Factors of Elevated Liver Enzymes in Japanese Women With Polycystic Ovary Syndrome

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