Non-alcoholic fatty liver disease in polycystic ovarian syndrome in Indian women.
Sujata SiwatchVirendra SinghLakhbir K DhaliwalSunita KumariKartar SinghPublished in: Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology (2021)
Non-alcoholic fatty liver disease (NAFLD) is a frequent occurrence in polycystic ovarian syndrome (PCOS). We studied the frequencies and characteristics of NAFLD in PCOS women. We compared various methods of detection of advanced fibrosis/cirrhosis. One hundred and forty women with PCOS and seventy controls, matched for age, were evaluated for the presence of NAFLD. Anthropometric variables, serum levels of aminotransferases, glucose, lipids and transient elastography were done. Thirty-six percent of the NAFLD patients had abnormal aminotransferases. In women presenting to an infertility clinic, NAFLD was higher in both obese and non-obese PCOS women, being present in 117 (83.6%) of PCOS cases and 32 (45.7%) of non-PCOS controls (p< .001). Fibroscan is helpful in evaluating for liver fibrosis in patients with NAFLD.Impact StatementWhat is already known on this subject? Polycystic ovarian syndrome (PCOS) has been associated with many long-term health complications including endometrial cancer, diabetes, hypertension and metabolic syndrome. The association of PCOS with NAFLD has been suggested. NAFLD is recognised as a leading cause of liver dysfunction which can progress to long-term sequel of cirrhosis.What do the results of this study add? In this study, asymptomatic women seeking treatment of infertility were screened for presence of NAFLD. The study shows a high prevalence of NAFLD in young Indian women. The prevalence was significantly higher in women with PCOS than non-PCOS women.What are the implications of these findings for clinical practice and/or further research? The findings of the study suggest that all infertile women, especially those with PCOS, should be screened for NAFLD. This will help in early identification and management of this condition and to avoid long-term consequences of liver dysfunction and cirrhosis. PCOS is an independent risk factor for the development of NAFLD in obese women. Liver ultrasound, serum levels of transaminases clinch the diagnosis. Short of liver biopsy, non-invasive tests like Fibroscan and NAFLD fibrosis score are useful to assess the stage of fibrosis.
Keyphrases
- polycystic ovary syndrome
- insulin resistance
- liver fibrosis
- metabolic syndrome
- adipose tissue
- type diabetes
- healthcare
- public health
- magnetic resonance imaging
- blood pressure
- mental health
- cardiovascular disease
- case report
- weight loss
- risk factors
- clinical practice
- pregnant women
- computed tomography
- bariatric surgery
- health information
- climate change
- pregnancy outcomes
- body composition
- ejection fraction
- fatty acid
- smoking cessation