Nonalcoholic fatty liver disease in women with polycystic ovary syndrome: associated factors and noninvasive fibrosis staging in a single Brazilian center.

Autor:	Taranto DOL; Serviço de Diagnóstico por Imagem do Hospital das Clínicas da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil.; Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil., Guimarães TCM; Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil., Couto CA; Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil.; Instituto Alfa de Gastroenterologia , Hospital das Clínicas da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil.; Departamento de Clínica Médica , Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil., Cândido AL; Departamento de Clínica Médica , Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil.; Ambulatório de Hiperandrogenismo, Serviço de Endocrinologia , Hospital das Clínicas da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil., Azevedo RCS; Ambulatório de Hiperandrogenismo, Serviço de Endocrinologia , Hospital das Clínicas da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil., Mattos FS; Departamento de Clínica Médica , Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil., Elias MLC; Departamento de Clínica Médica , Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil., Reis FM; Ambulatório de Hiperandrogenismo, Serviço de Endocrinologia , Hospital das Clínicas da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil.; Departamento de Ginecologia e Obstetrícia , Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil., Rocha ALL; Ambulatório de Hiperandrogenismo, Serviço de Endocrinologia , Hospital das Clínicas da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil.; Departamento de Ginecologia e Obstetrícia , Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil., Faria LC; Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil.; Instituto Alfa de Gastroenterologia , Hospital das Clínicas da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil.; Departamento de Clínica Médica , Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG , Brasil.
Jazyk:	angličtina
Zdroj:	Archives of endocrinology and metabolism [Arch Endocrinol Metab] 2020 May-Jun; Vol. 64 (3), pp. 235-242.
DOI:	10.20945/2359-3997000000242
Abstrakt:	Objective: Polycystic ovary syndrome (PCOS) is a recognized risk factor for nonalcoholic fatty liver disease (NAFLD). The aims of this study were to investigate the prevalence and factors associated with NAFLD in women with PCOS and evaluate noninvasive indices of hepatic fibrosis in patients with PCOS and NAFLD. Subjects and Methods: Patients with PCOS (n = 87) and women without PCOS (n = 40; controls) were included. NAFLD was diagnosed by abdominal ultrasonography after exclusion of alcohol consumption and viral or autoimmune liver disease. Anthropometric, clinical and metabolic variables, homeostasis model assessment of insulin resistance (HOMA-IR) index, lipid accumulation product (LAP), FIB-4 index, NAFLD score, and transient elastography (TE; FibroScan) were obtained in subsets of patients with PCOS and NAFLD. Results: A total of 87 patients with PCOS were included (mean age: 34.4 ± 5.7 years, mean body mass index [BMI]: 34.7 ± 4.7 kg/m 2 ). NAFLD was present in 67 (77.0%) patients with PCOS versus 21 of 40 (52.5%) controls (p = 0.005). Women with PCOS and liver steatosis, compared with their NAFLD-free counterparts, had higher values of BMI, waist circumference, triglycerides, total cholesterol, alanine and aspartate aminotransferases, and γ-glutamyltransferase, along with higher frequencies of obesity, metabolic syndrome, and insulin resistance. NAFLD was independently associated with waist circumference, serum triglycerides, and alanine aminotransferase levels. The FIB-4 index was not compatible with advanced fibrosis in any of the evaluated patients, while NAFLD score and TE were compatible with advanced liver fibrosis in 1 of 26 (3.8%) and 3 of 25 (12%) patients, respectively. Conclusion: Women with PCOS had a high risk of NAFLD, and a combination of both was associated with central obesity, dyslipidemia, insulin resistance, and metabolic syndrome. Noninvasive methods suggested low rates of severe hepatic fibrosis in Brazilian women with PCOS. Arch Endocrinol Metab. 2020;64(3):235-42.
Databáze:	MEDLINE
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