Volume 11, Issue 9 (12-2013)                   IJRM 2013, 11(9): 725-0 | Back to browse issues page

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Qu Z, Zhu Y, Jiang J, Shi Y, Chen Z. The clinical characteristics and etiological study of nonalcoholic fatty liver disease in Chinese women with PCOS. IJRM 2013; 11 (9) :725-0
URL: http://ijrm.ir/article-1-466-en.html
1- Division of Ultrasonography, Shandong Provincial Hospital, 324 Jingwu Road, Jinan, Shandong 250021, China
2- Medical Informatics Center, Peking University, 38 Xueyuan Road, Beijing 100191, China , gzyh@hsc.pku.edu.cn
3- Reproductive Medicine Center, Shandong University, 157 Jingliu Road, Jinan, Shandong 250021, China
Abstract:   (3250 Views)
Background: Polycystic ovary syndrome (PCOS) is highly associated with non-alcoholic fatty liver disease (NAFLD). There are extensive ethnic differences in the clinical manifestations, pathological changes, and ovarian changes in women with PCOS.
Objective: To investigate the prevalence and clinical characteristics of NAFLD in Chinese women with PCOS.
Materials and Methods: Non-pregnant women with PCOS (N= 602) and matched controls without PCOS (N=588) were recruited. Basal endocrine, oral glucose tolerance test, insulin release level, lipid level, blood pressure, and body mass index (BMI) were measured. Liver biochemical and B-hepatitis and C-hepatitis indices were determined.
Results: NAFLD was significantly more prevalent in women with PCOS than controls (32.9% vs. 18.5%) and included 113 (57.1%) mild, 75 (37.8%) moderate and 10 (5.1%) severe cases. Luteinizing hormone was significantly lower in PCOS women with NAFLD than without NAFLD. In the PCOS group, NAFLD prevalence and severity increased with BMI. The liver index was significantly higher (p<0.001), and the quantitative insulin sensitivity check index and high density lipoprotein cholesterol were significantly lower (p<0.001) in the PCOS group than controls. Insulin resistance, abdominal obesity, diabetes mellitus, abnormal glucose tolerance, liver dysfunction, dyslipidemia, hypertension, and metabolic syndrome were significantly more prevalent in the NAFLD group than controls.
Conclusion: Chinese women with PCOS have a high prevalence of mostly mild and moderate NAFLD, not significantly associated with hyperandrogenism that increased significantly with BMI. Insulin resistance and metabolic abnormalities are important factors associated with NAFLD. Chinese women with BMI ≥24 kg/mP2P should be screened for NAFLD.
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1. Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 1935; 29: 181-191. [DOI:10.1016/S0002-9378(15)30642-6]
2. Laven JS, Imani B, Eijkemans MJ, Fauser BC. New approaches to PCOS and other forms of anovulation. Obstet Gynecol Surv 2002; 57: 755-767. [DOI:10.1097/00006254-200211000-00022]
3. The Rotterdam ESHRE/ASRM -Sponsored PCOS Work shop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004; 19: 41-47. [DOI:10.1093/humrep/deh098]
4. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med 2002; 346: 1221-1231. 5. Brunt EM. Nonalcoholic steatohepatitis: definition and pathology. Semin Liver Dis 2001; 21: 3-16.
5. Brunt EM. Nonalcoholic steatohepatitis: definition and pathology. Semin Liver Dis 2001; 21: 3-16. [DOI:10.1055/s-2001-12925]
6. Gambarin-Gelwan M, Kinkhabwala SV, Schiano TD, Bodian C, Yeh HC, Futterweit W. Prevalence of nonalcoholic fatty liver disease in women with polycystic ovary syndrome. Clin Gastroenterol Hepatol 2007; 5: 496-501. [DOI:10.1016/j.cgh.2006.10.010]
7. Cerda C, Pérez-Ayuso RM, Riquelme A, Soza A, Villaseca P, Sir-Petermann T, et al. Nonalcoholic fatty liver disease in women with polycystic ovary syndrome. J Hepatol 2007; 47: 412-417. [DOI:10.1016/j.jhep.2007.04.012]
8. Adams LA, Feldstein A, Lindor KD, Angulo P. Nonalcoholic fatty liver disease among women with hypothalamic and pituitary dysfunction. Hepatology 2004; 39: 909-914. [DOI:10.1002/hep.20140]
9. Browning JD, Horton JD. Molecular mediators of hepatic steatosis and liver injury. J Clin Invest 2004; 114: 147-152. [DOI:10.1172/JCI200422422]
10. Azzout-Marniche D, Becard D, Guichard C, Foretz M, Ferré P, Foufelle F. Insulin effects on sterol regulatory-element-binding protein-1c (SREBP-1c) transcriptional activity in rat hepatocytes. Biochem J 2000; 350: 389-393. [DOI:10.1042/bj3500389]
11. The Rotterdam ESHRE/ASRM-Sponsored PCOS Work shop Group. Revised 2003 consensus on diagnostic criteria and long term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81: 19-25. [DOI:10.1016/j.fertnstert.2003.10.004]
12. Choo V. WHO reassesses appropriate body- mass index for Asian populations. Lancet 2002; 360: 235. [DOI:10.1016/S0140-6736(02)09512-0]
13. Zhou BF. Cooperative Meta-Analysis Group of the Working Group on Obesity in China. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults--study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci 2002; 15: 83-96.
14. Chen CM. Overview of obesity in mainland China. Obes Rev 2008; 9 (Suppl.) 1: 14-21.
15. Bonora E, Targher G, Alberiche M, Bonadonna RC,Saggiani F, Zenere MB, et al. Homeostasis model assessment closely mirrors the glucose clamp technique in the assessment of insulin sensitivity: studies in subjects with various degrees of glucose tolerance and insulin sensitivity. Diabetes Care 2000; 23: 57-63. [DOI:10.2337/diacare.23.1.57]
16. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and -cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412-419. [DOI:10.1007/BF00280883]
17. Galvin P, Ward G, Walters J, Pestell R, Koschmann M, Vaag A, et al. A simple method for quantitation of insulin sensitivity and insulin release from an intravenous glucose tolerance test. Diabet Med 1992; 9: 921-928. [DOI:10.1111/j.1464-5491.1992.tb01732.x]
18. Katz A, Nambi SS, Mather K, Baron AD, Follmann DA, Sullivan G, et al. Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans. J Clin Endocrinol Metab 2000; 85: 2402-2410. [DOI:10.1210/jcem.85.7.6661]
19. Chen H, Sullivan G, Quon MJ. Assessing the Predictive Accuracy of QUICKI as a Surrogate Index for Insulin Sensitivity Using a Calibration Model. Diabetes 2005; 54: 1914-1925. [DOI:10.2337/diabetes.54.7.1914]
20. Neuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: summary of an AASLD Single Topic Conference. Hepatology 2003; 37: 1202-1219. [DOI:10.1053/jhep.2003.50193]
21. Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ. Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology 1999; 116: 1413-1419. [DOI:10.1016/S0016-5085(99)70506-8]
22. Scatarige JC, Scott WW, Donovan PJ, Siegelman SS, Sanders RC. Fatty infiltration of the liver: ultrasonographic and computed tomographic correlation. J Ultrasound Med 1984; 3: 9-14. [DOI:10.7863/jum.1984.3.1.9]
23. Kiddy DS, Hamilton-Fairley D, Bush A, Short F, Anyaoku V, Reed MJ, et al. Improvement in endocrine and ovarian function during dietary treatment of obese women with polycystic ovary syndrome. Clin Endocrinol 1992; 36: 105-111. [DOI:10.1111/j.1365-2265.1992.tb02909.x]
24. Norman RJ, Davies MJ, Lord J, Moran LJ. The role of lifestyle modification in polycystic ovary syndrome. Trends Endocrinol Metab 2002; 13: 251-257. [DOI:10.1016/S1043-2760(02)00612-4]
25. Norman RJ, Noakes M, Wu R, Davies MJ, Moran L, Wang JX. Improving reproductive performance in overweight/obese women with effective weight management. Hum Reprod Update 2004; 10: 267-280. [DOI:10.1093/humupd/dmh018]
26. Setji TL, Holland ND, Sanders LL, Pereira KC, Diehl AM, Brown AJ. Nonalcoholic steatohepatitis and nonalcoholic fatty liver disease in young women with polycystic ovary syndrome. J Clin Endocrinol Metab 2006; 91: 1741-1747. [DOI:10.1210/jc.2005-2774]
27. DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil Steril 2005; 83: 1454-1460. [DOI:10.1016/j.fertnstert.2004.11.070]
28. Marchesini G, Avagnina S, Barantani EG, Ciccarone AM, Corica F, Dall'Aglio E, et al. Aminotransferase and gamma-glutamyltranspeptidase levels in obesity are associated with insulin resistance and the metabolic syndrome. J Endocrinol Invest 2005; 28: 333-339. [DOI:10.1007/BF03347199]
29. Paradis V, Perlemuter G, Bonvoust F, Dargere D, Parfait B, Vidaud M, et al. High glucose and hyperinsulinemia stimulate connective tissue growth factor expression: a potential mechanism involved in progression to fibrosis in nonalcoholic steatohepatitis. Hepatology 2001; 34: 738-744. [DOI:10.1053/jhep.2001.28055]
30. Pagán YL, Srouji SS, Jimenez Y, Emerson A, Gill S, Hall JE. Inverse relationship between luteinizing hormone and body mass index in polycystic ovarian syndrome: investigation of hypothalamic and pituitary contributions. J Clin Endocrinol Metab 2006; 91: 1309-1316. [DOI:10.1210/jc.2005-2099]
31. Vassilatou E, Lafoyianni S, Vryonidou A, Ioannidis D, Kosma L, Katsoulis K, et al. Increased androgen bioavailability is associated with non-alcoholic fatty liver disease in women with polycystic ovary syndrome. Hum Reprod 2010; 25: 212-220. [DOI:10.1093/humrep/dep380]
32. Baranova A, Tran TP, Birerdinc A, Younossi ZM. Systematic review: association of polycystic ovary syndrome with metabolic syndrome and non-alcoholic fatty liver disease. Aliment Pharmacol Ther 2011; 33: 801-814. [DOI:10.1111/j.1365-2036.2011.04579.x]
33. Hossain N, Stepanova M, Afendy A, Nader F, Younossi Y, Rafiq N, et al. Non-alcoholic steatohepatitis (NASH) in patients with polycystic ovarian syndrome (PCOS). Scand J Gastroenterol 2011; 46: 479-484. [DOI:10.3109/00365521.2010.539251]

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