Lack of association between early menopause and non-alcoholic fatty liver disease in postmenopausal women

Park, S. H.; Park, Y. E.; Lee, J.; Choi, Joon Hyuk; Heo, Nae–Yun; Park, J.; Kim, T. O.; Moon, Young Soo; Kim, H. K.; Jang, Hyuk Jai; Park, H. Y.; Jeong, Chul-Hoi; Suk, Ki Tae; Kim, Dong Joon

doi:10.1080/13697137.2019.1650018

Cited by 6 publications

(4 citation statements)

References 26 publications

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“…In female mice, ERα was found to counteract the accumulation of lipids in the liver following excessive dietary fat intake, by inhibiting lipid synthesis and promoting mitochondrial fatty acid β-oxidation (57). Although early menopause was not associated with NAFLD in a previous study (58), it may have lacked power due to the limited number of participants with early menopause. Further studies including larger populations are warranted to clarify the role of estrogen insufficiency and sex hormone abnormalities in the development of NAFLD.…”

Section: Discussionmentioning

confidence: 89%

Long or Irregular Menstrual Cycles and Risk of Prevalent and Incident Nonalcoholic Fatty Liver Disease

Cho

Chang

Kang

et al. 2022

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context The association of menstrual cycle length and irregularity with the risk of non-alcoholic fatty liver disease (NAFLD) is unknown. Objective We examined this association in large cross-sectional and cohort studies. Methods The cross-sectional study included 72 092 women younger than 40 years who underwent routine health examinations; the longitudinal analysis included the subset of 51 118 women without NAFLD at baseline. Long or irregular cycles were defined as menstrual cycles of 40 days or longer or too irregular to estimate. Abdominal ultrasonography was performed to identify NAFLD. Multivariable Cox proportional hazard regression analyses were performed to estimate hazard ratios (HRs) and 95% CIs for incident NAFLD according to menstrual cycle regularity and length, with 26- to 30-day cycles as the reference. Results At baseline, 27.7% had long or irregular menstrual cycles and 7.1% had prevalent NAFLD. Long or irregular menstrual cycles were positively associated with prevalent NAFLD. During a median follow-up of 4.4 years, incident NAFLD occurred in 8.9% of women. After adjustment for age, body mass index, insulin resistance, and other confounders, the multivariable-adjusted HR for NAFLD comparing long or irregular menstrual cycles to the reference group was 1.22 (95% CI, 1.14-1.31); this association strengthened in the time-dependent analysis with an HR of 1.49 (95% CI, 1.38-1.60). Conclusion Long or irregular menstrual cycles were associated with increased risk of both prevalent and incident NAFLD in young, premenopausal women. Women with long or irregular menstrual cycles may benefit from lifestyle modification advice to reduce the risk of NAFLD and associated cardiometabolic diseases.

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Section: Discussionmentioning

confidence: 89%

Long or Irregular Menstrual Cycles and Risk of Prevalent and Incident Nonalcoholic Fatty Liver Disease

Cho

Chang

Kang

et al. 2022

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…Two studies did not provide any evidence regarding the association of menopause with NAFLD risk. In a cross-sectional study by Park et al [ 55 ], compared with normal menopausal women, early or late menopausal women had no significant differences in the odds ratios (ORs) of NAFLD: OR = 1.05, 95% CI, 0.83–1.32, and OR = 1.02, 95% CI, 0.75–1.39, respectively. Accordingly, in a study by Veronese et al [ 56 ] the number of years since the onset of menopause was not associated with the severity of liver steatosis in NAFLD ( p for trend = 0.74; Spearman correlation = 0.04; 95% CI: -0.09 to 0.17), whereas all the indexes of adiposity and the number of metabolic syndrome factors were associated with a higher liver steatosis score.…”

Section: Resultsmentioning

confidence: 99%

“… Insulin resistance (homeostatic model assessment of insulin resistance ≥ 3) ( p < 0.05) was higher in the group of women with NAFLD diagnosis who did not refer to the use of hormone replacement therapy. Park et al, 2020 [ 55 ] Cross-sectional study Korea 4354 postmenopausal women Early, normal, and late menopause were defined as age at menopause <45 years, 45–54 years, and ≥55 years, respectively. Age, BMI, ALT, high FBG, HDL, LDL, TG, HOMA-IR, HT, GGT, HTN Women who participated in the 2010–2012 Korea National Health and Nutrition Examination Survey.…”

Section: Table A1mentioning

confidence: 99%

The Effect of Menopausal Status, Insulin Resistance and Body Mass Index on the Prevalence of Non-Alcoholic Fatty Liver Disease

Ntikoudi,

Spyrou,

Evangelou

et al. 2024

Healthcare

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Non-alcoholic fatty liver disease (NAFLD) is common and presents in a large proportion—up to 30%—of the global adult female population. Several factors have been linked with NAFLD in women, such as age, obesity, and metabolic syndrome. To extract appropriate details about the topic, we conducted an extensive search using various medical subject headings and entry terms including ‘Menopause’, ‘Non-alcoholic fatty liver disease’, ‘Insulin resistance’, and ‘BMI’. This exhaustive search resulted in a total of 180 studies, among which only 19 were able to meet the inclusion criteria. While most of these studies indicated a significant rise in NAFLD prevalence among postmenopausal women, two did not find strong evidence linking menopause with NAFLD. Moreover, it was observed that women with NAFLD had higher insulin resistance levels and BMIs compared to those without the condition. In summary, it is important to consider specific factors like risk profile, hormonal status, and age along with metabolic components when treating women presenting with NAFLD. There is need for data-driven research on how gender affects the sensitivity of biomarkers towards NAFLD as well as the development of sex-specific prediction models—this would help personalize management approaches for women, who stand to benefit greatly from such tailored interventions.

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“…16) In addition, many studies on liver fibrosis in Korea have been successfully conducted using FIB-4. [17][18][19][20][21][22]…”

Section: Definition Of Liver Fibrosismentioning

confidence: 99%

Association between History of Pregnancy and Liver Fibrosis Using Fibrosis-4 Index in Korean Postmenopausal Women: A Nationwide Population-Based Study

et al. 2022

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Background: The association between a history of pregnancy and liver fibrosis remains unclear. Herein, we investigated the association between reproductive factors, including a history of pregnancy and liver fibrosis, in postmenopausal Korean women.Methods: This study used nationally representative, population-based data collected from the Korea National Health and Nutrition Examination Survey 2008–2017. Of 14,624 women with natural menopause, 11,085 with no previous history of any type of cancer, hepatitis, or chronic heavy alcohol consumption were enrolled. We investigated the reproductive factors, including a history of pregnancy, total reproductive years, age at menarche and menopause, and oral contraceptive use. Liver fibrosis was defined as a Fibrosis-4 index score ≥2.67 kg/m<sup>2</sup>.Results: Of the study participants, 372 (3.3%) had advanced liver fibrosis. Multivariable logistic regression analysis showed that women with a history of more than one pregnancy were associated with a lower risk of liver fibrosis compared to women who had never been pregnant, after adjusting for potential confounders (adjusted odds ratio, 0.30; 95% confidence interval, 0.15–0.59). The risk of liver fibrosis did not increase significantly with an increasing number of pregnancies (P for trend=0.135). Other reproductive factors, including total reproductive years, age at menopause and menarche, and oral contraceptive use, were not significantly associated with liver fibrosis.Conclusion: Postmenopausal women who had experienced one or more pregnancies had a reduced risk of liver fibrosis. Our findings reveal a potential protective role of pregnancy against liver fibrosis.

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Lack of association between early menopause and non-alcoholic fatty liver disease in postmenopausal women

Cited by 6 publications

References 26 publications

Long or Irregular Menstrual Cycles and Risk of Prevalent and Incident Nonalcoholic Fatty Liver Disease

Long or Irregular Menstrual Cycles and Risk of Prevalent and Incident Nonalcoholic Fatty Liver Disease

The Effect of Menopausal Status, Insulin Resistance and Body Mass Index on the Prevalence of Non-Alcoholic Fatty Liver Disease

Association between History of Pregnancy and Liver Fibrosis Using Fibrosis-4 Index in Korean Postmenopausal Women: A Nationwide Population-Based Study

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