Increased androgen bioavailability is associated with non-alcoholic fatty liver disease in women with polycystic ovary syndrome
Increased androgen bioavailability is associated with non-alcoholic fatty liver disease in women with polycystic ovary syndrome
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DOI：
10.1093/humrep/dep380
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发表时间：
2010-01-01
影响因子：
6.1
通讯作者：
Tzavara, I.
中科院分区：
文献类型：
--
作者：
Vassilatou, E.;Lafoyianni, S.;Tzavara, I.
在多囊卵巢综合征（PCOS）患者中发现转氨酶水平异常和/或肝脂肪变性（HS）的超声证据的患病率增加。然而，与PCOS患者非酒精性脂肪性肝病（NAFLD）相关的因素仍在研究中。本病例对照研究的目的是调查PCOS患者中NAFLD的存在情况，并评估与这种情况相关的因素。对57例绝经前PCOS患者和60例年龄和体重匹配的对照妇女进行了前瞻性研究，这些妇女没有或很少饮酒。在排除继发性肝病的原因后，测定人体测量变量、生化和激素参数，并通过腹部超声和生化检测评估NAFLD。采用稳态模型胰岛素抵抗指数（HOMA-IR）评估胰岛素抵抗，并计算游离雄激素指数（FAI）（36.8%）与12/60对照组（20.0%，P < 0.05）和血清转氨酶水平异常（>= 40 IU/l）[13/57例患者（22.8%）vs 2/60例对照（3.3%，P < 0.01）]。所有代谢综合征患者和对照组均患有HS。与HS相关的因素有PCOS诊断、年龄较大、BMI、腰围（WC）、HOMA-IR和FAI值增加以及高密度脂蛋白胆固醇和性激素结合球蛋白水平降低。在校正年龄、BMI和WC后，PCOS患者HS与对照组相比的OR为3.55（95%CI：1.02-5.35）AFLD在PCOS患者中很常见，并且可能与雄激素生物利用度增加以及代谢异常有关。建议在PCOS患者中进行肝脏评估，特别是在代谢综合征患者中。
Increased prevalence of abnormal aminotransferase levels and/or ultrasonographic evidence of hepatic steatosis (HS) have been found in women with polycystic ovary syndrome (PCOS). However, factors associated with non-alcoholic fatty liver disease (NAFLD) in PCOS are still under investigation. The aim of this case-control study was to investigate the presence of NAFLD and to assess factors associated with this condition in PCOS patients.A prospective study of 57 premenopausal PCOS patients and 60 age- and weight-matched control women, with a history of no or minimal alcohol consumption was conducted. Anthropometric variables, biochemical and hormonal parameters were determined and NAFLD was evaluated by abdominal ultrasonography and biochemical testing, after excluding causes of secondary liver disease. Insulin resistance was assessed by homeostasis model assessment of insulin resistance (HOMA-IR) and free androgen index (FAI) was calculated.PCOS patients had an increased prevalence of HS [21/57 patients (36.8%) versus 12/60 controls (20.0%), P < 0.05] and abnormal (>= 40 IU/l) serum aminotransferase levels [13/57 patients (22.8%) versus 2/60 controls (3.3%), P < 0.01] than controls. All patients and controls with metabolic syndrome had HS. Factors associated with HS were PCOS diagnosis, older age, increased BMI, waist circumference (WC), HOMA-IR and FAI values and decreased high-density lipid cholesterol and sex hormone binding globulin levels. PCOS patients had an OR of 3.55 (95% CI: 1.02-5.35) for HS versus controls, after adjustment for age, BMI and WC.NAFLD is common in PCOS patients and increased androgen bioavailability may be implicated, in combination with metabolic abnormalities. Liver evaluation is proposed in PCOS patients, especially in those with metabolic syndrome.