Polycystic Ovary Syndrome with Hyperandrogenism Is Characterized by an Increased Risk of Hepatic Steatosis Compared to Nonhyperandrogenic PCOS Phenotypes and Healthy Controls, Independent of Obesity and Insulin Resistance
Polycystic Ovary Syndrome with Hyperandrogenism Is Characterized by an Increased Risk of Hepatic Steatosis Compared to Nonhyperandrogenic PCOS Phenotypes and Healthy Controls, Independent of Obesity and Insulin Resistance
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DOI：
10.1210/jc.2012-1382
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发表时间：
2012-10-01
影响因子：
5.8
通讯作者：
Cuthbertson, Daniel J.
中科院分区：
文献类型：
--
作者：
Jones, Helen;Sprung, Victoria S.;Cuthbertson, Daniel J.
背景：非酒精性脂肪肝在患有多囊卵巢综合征 (PCOS) 的女性中可能很明显，这两种情况都与肥胖和胰岛素抵抗有关。然而，很少有研究解释 PCOS 中肥胖的高患病率。目的：本研究的目的是确定与年龄和体重指数 (BMI) 相似的健康对照相比，PCOS 是否与肝脂肪变性独立相关，以及脂肪变性是否与高雄激素血症相关。设计和背景：我们在两个三级转诊中心进行了一项横断面病例对照研究。患者：29 名根据鹿特丹标准诊断的 PCOS 女性[年龄] 28岁； 95% 置信区间 (CI)，26-31；体重指数，33公斤/米(2)；研究人员对 22 名健康对照者（29 岁；95% CI，28-31；BMI，30 kg/m(2)；95% CI，28-33）进行了研究。方法：质子磁共振波谱法定量肝脏和骨骼肌脂肪；全身磁共振成像量化了内部、内脏和皮下脂肪组织体积。使用 t 检验评估 PCOS 和对照之间的差异，以及使用协方差分析评估高雄激素 (HA) PCOS、正常雄激素 (NA) 的 PCOS 和对照之间的差异。结果：对 BMI 进行统计调整后，HA-PCOS 的肝脏脂肪显着高于 NA-PCOS（3.7%；95% CI，0.6-13.1）和对照（2.1%；95% CI， 0.3-6.6）。同样，在对胰岛素抵抗、内部和内脏脂肪组织体积的稳态模型评估进行调整后，与 NA-PCOS 和对照组相比，HA-PCOS 的肝脏脂肪仍然显着更高。 结论：这些数据表明，HA-PCOS 与肝脏脂肪变性相关，与肥胖和胰岛素抵抗无关。 (临床内分泌代谢杂志 97: 3709-3716, 2012)
Context: Nonalcoholic fatty liver disease may be evident in women with polycystic ovary syndrome (PCOS), both conditions being associated with obesity and insulin resistance. However, few studies have accounted for the high prevalence of obesity in PCOS.Objective: The aim of this study was to determine whether PCOS is independently associated with hepatic steatosis, compared with healthy controls of similar age and body mass index (BMI), and whether steatosis is associated with hyperandrogenemia.Design and Setting: We conducted a cross-sectional, case-control study at two tertiary referral centers.Patients: Twenty-nine women with PCOS diagnosed by the Rotterdam criteria [aged 28 yr; 95% confidence interval (CI), 26-31; BMI, 33 kg/m(2); 95% CI, 31-36] and 22 healthy controls (aged 29 yr; 95% CI, 28-31; BMI, 30 kg/m(2); 95% CI, 28-33) were studied.Methods: Proton-magnetic resonance spectroscopy quantified hepatic and skeletal muscle fat; whole body magnetic resonance imaging quantified internal, visceral, and sc adipose tissue volumes. Differences were assessed between PCOS and controls using t tests, and between hyperandrogenic (HA) PCOS, PCOS with normal androgens (NA), and controls using analysis of covariance.Results: After statistical adjustment for BMI, HA-PCOS had significantly higher liver fat vs. NA-PCOS (3.7%; 95% CI, 0.6-13.1) and vs. controls (2.1%; 95% CI, 0.3-6.6). Similarly, after adjustment for homeostasis model assessment for insulin resistance, internal and visceral adipose tissue volumes, liver fat remained significantly greater in HA-PCOS compared to NA-PCOS and controls.Conclusion: These data suggest that HA-PCOS is associated with hepatic steatosis, independent of obesity and insulin resistance. (J Clin Endocrinol Metab 97: 3709-3716, 2012)