Prevalence and Risk Factors of Elevated Liver Enzymes in Japanese Women With Polycystic Ovary Syndrome.
Prevalence and Risk Factors of Elevated Liver Enzymes in Japanese Women With Polycystic Ovary Syndrome.
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DOI：
10.14740/jocmr3639
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发表时间：
2018-12
期刊：
影响因子：
--
通讯作者：
Nagai N
中科院分区：
文献类型：
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作者：
Minato S;Sakane N;Kotani K;Nirengi S;Hayashi I;Suganuma A;Yamaguchi K;Takakura K;Nagai N
多囊卵巢综合征（PCOS）是育龄妇女常见的内分泌疾病。虽然PCOS与肥胖和胰岛素抵抗的风险增加有关，但对日本PCOS女性非酒精性脂肪肝（NAFLD）的患病率和风险因素知之甚少。我们估计了日本PCOS妇女中肝酶升高的患病率和危险因素，作为NAFLD的指标。我们回顾性分析了2000年1月至2016年9月期间在日本京都医疗中心妇科就诊的102名育龄女性。入选标准为采用国际疾病分类第10版临床修订版（ICD-10）编码确诊PCOS。排除标准为有肝病史、体重指数（BMI）和血清丙氨酸氨基转移酶（ALT）数据缺失以及妊娠的女性。年龄、体重指数、血糖、血脂、肝酶和性激素水平等数据均来自医疗记录。肝酶升高定义为ALT > 19 IU/L。计算肝酶升高风险因素的最佳临界值，以使用受试者操作特征（ROC）的曲线下面积（AUC）确定肝酶升高的预测因素。肝酶升高的发生率为33.3%。PCOS组BMI明显高于无肝酶升高组（25.3 vs 20.7kg/m2，P < 0.05）。使用BMI和血糖和睾酮水平进行ROC分析，因为BMI和血糖显示组间差异，睾酮与脂肪肝相关。包括BMI、血糖和睾酮水平的模型的AUC为0.861（敏感性，66.7%;特异性，100%）。这些发现表明，肝酶升高在PCOS女性中很常见。使用BMI、血糖和睾酮水平的算法可能有助于确定PCOS女性的肝酶升高。我们的发现可能对日本PCOS女性NAFLD的研究有用，因为之前的几项研究表明肝酶升高与NAFLD的潜在存在有关。需要进一步检查，包括腹部超声检查和/或肝活检数据，以确认这些结果。
Polycystic 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. We 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). The 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%). These 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.