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Hormones

, Volume 13, Issue 4, pp 519–531 | Cite as

Non-alcoholic fatty liver disease in women with polycystic ovary syndrome: assessment of non-invasive indices predicting hepatic steatosis and fibrosis

  • Stergios A. Polyzos
  • Dimitrios G. Goulis
  • Jannis Kountouras
  • Gesthimani Mintziori
  • Panagiotis Chatzis
  • Efstathios Papadakis
  • Ilias Katsikis
  • Dimitrios Panidis
Research paper

Abstract

OBJECTIVE

Insulin resistance contributes to the pathogenesis of both polycystic ovary syndrome (PCOS) and non-alcoholic fatty liver disease (NAFLD). The main aim of the present study was the evaluation of non-invasive indices of hepatic steatosis and fibrosis in PCOS women with or without metabolic syndrome (MetS).

DESIGN

In this cross-sectional study, three non-invasive indices for hepatic steatosis [NAFLD liver fat score, lipid accumulation product (LAP) and hepatic steatosis index (HIS)] and four for fibrosis [FIB-4, aspartate aminotransferase (AST)-to-Platelet Ratio Index (APRI), body mass index (BMI)-Age-Alanine aminotransferase (ALT)-Triglycerides (BAAT) and BMI AST/ALT Ratio Diabetes (BARD)] were calculated in 314 PCOS women (77 with, 237 without MetS) and 78 controls.

RESULTS

All steatosis indices were significantly higher in the PCOS than the control group (NAFLD liver fat score: −0.139±0.117 vs. −0.976±0.159, p<0.001; LAP: 43.3±1.9 vs. 34.7±3.1, p = 0.036; HIS: 44.6±0.5 vs. 42.1±0.8, p = 0.016). FIB-4 and BAAT [fibrosis stage (F)2-4] were higher in the PCOS group (0.480±0.020 vs. 0.400±0.013, p<0.001; and 15.6% vs. 5.1%, respectively), whereas APRI and BARD were not. All steatosis indices were significantly higher in PCOS women with than without MetS (NAFLD liver fat score: 1.874±0.258 vs. −0.793±0.099, p < 0.001; LAP: 76.8±4.9 vs. 33.4 ± 1.4, p < 0.001; and HIS: 49.8±1 vs. 43±0.5, p<0.001). Of the fibrosis indices, only BAAT (F2-4: 50.6% vs. 4.2%) was higher in PCOS women with MetS.

CONCLUSIONS

Non-invasive indices of hepatic steatosis were significantly higher in PCOS, especially in the presence of MetS, whereas indices of hepatic fibrosis yielded controversial results. Further studies are warranted to evaluate the long-term outcomes of hepatic steatosis and fibrosis indices in PCOS women.

Key Words

APRI FIB-4 Hepatic steatosis index Insulin resistance Lipid accumulation product Metabolic syndrome NAFLD liver fat score Steatosis 

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Copyright information

© Hellenic Endocrine Society 2014

Authors and Affiliations

  • Stergios A. Polyzos
    • 1
  • Dimitrios G. Goulis
    • 2
  • Jannis Kountouras
    • 1
  • Gesthimani Mintziori
    • 2
  • Panagiotis Chatzis
    • 3
  • Efstathios Papadakis
    • 3
  • Ilias Katsikis
    • 3
  • Dimitrios Panidis
    • 3
  1. 1.Second Medical Clinic, Ippokration HospitalAristotle University of ThessalonikiThessalonikiGreece
  2. 2.Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Papageorgiou HospitalAristotle University of ThessalonikiThessalonikiGreece
  3. 3.Division of Endocrinology and Human Reproduction, Second Department of Obstetrics and Gynecology, Ippokration HospitalAristotle University of ThessalonikiThessalonikiGreece

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