Polycystic ovary syndrome with feasible equivalence to overweight as a risk factor for non-alcoholic fatty liver disease development and severity in Mexican population

Salva-Pastor, Nicolás; López-Sánchez, Guillermo Nahúm; Chávez-Tapia, Norberto C.; Audifred-Salomón, Jorge Román; Niebla-Cárdenas, Danniela; Topete-Estrada, Rafael; Pereznuñez-Zamora, Helga; Vidaltamayo-Ramírez, Rafael; Báez-Arellano, Margarita Elodia; Uribe, Misael; Nuño‐Lámbarri, Natalia

doi:10.1016/j.aohep.2020.01.004

Cited by 26 publications

(22 citation statements)

References 30 publications

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“…This emerging association between NAFLD and PCOS was substantiated by evidence of common pathogenic mechanisms between the two conditions (16,17). Recent studies confirmed that both insulin resistance and hyperandrogenism are key players of liver damage in women with PCOS, with a major role of the second one in non-obese patients (18,19). PCOS, one of the most common endocrine disorders, affects 5-10% of reproductive-aged women (20), presenting not only a reproductive, but also an oncological and a cardio-metabolic burden.…”

Section: Introductionmentioning

confidence: 92%

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SHBG as a Marker of NAFLD and Metabolic Impairments in Women Referred for Oligomenorrhea and/or Hirsutism and in Women With Sexual Dysfunction

et al. 2021

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PCOS is one of the most common endocrine disorders and NAFLD is one of its most dangerous metabolic consequences. The diagnosis of NAFLD is not a practical task and the condition is at risk of being overlooked. The use of simpler but still reliable surrogate markers is necessary to identify women with a high likelihood of NAFLD. The aim of this study was to evaluate the clinical correlates of NAFLD Liver Fat Score (NAFLD-LFS) in women with oligomenorrhea and/or hirsutism. Furthermore, the study aimed to evaluate whether, among the hormonal parameters evaluated in such women, possible hallmarks of NAFLD may be identified. To this purpose, 66 women who attended our Outpatient Clinic for oligomenorrhea and/or hyperandrogenism were included in the study. In order to validate the results obtained in the first cohort, a second independent sample of 233 women evaluated for female sexual dysfunction (FSD) was analyzed. In cohort 1, NAFLD-LFS positively correlated with metabolic and inflammatory parameters. Among the hormone parameters, NAFLD-LFS showed no significant relationships with androgens but a significant negative correlation with SHBG (p<0.0001) that therefore appeared as a candidate hallmark for pathologic NAFLD-LFS. The ROC analysis showed a significant accuracy (81.1%, C.I.69.1-93.0, p <0.0001) for SHBG in identifying women with a pathological NAFLD-LFS. In particular, a SHBG 33.4 nmol/l was recognized as the best threshold, with a sensitivity of 73.3% and a specificity of 70.7%. In order to validate this SHBG as a marker of metabolic impairment possible related with the presence of NAFLD, we tested this threshold in cohort 2. FSD women with SHBG <33.4 nmol/l had worse metabolic parameters than women with SHBG ≥33.4 nmol/l and a significantly higher NAFLD-LFS even after adjusting for confounders (B=4.18 [2.05; 6.31], p=0.001). In conclusion, this study provides a new evidence in the diagnostic process of NAFLD, showing that the measurement of SHBG, which is routinely assessed in the workup of women referred for possible PCOS, could identify women at higher metabolic risk, thus detecting those who may deserve further targeted diagnostic assessment.

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Section: Introductionmentioning

confidence: 92%

“…FSD women with SHBG <33.4 nmol/l had worse metabolic parameters than women with SHBG ≥33.4 nmol/l and a significantly higher NAFLD-LFS even after adjusting for confounders (B=4. 18 [2.05; 6.31], p=0.001). In conclusion, this study provides a new evidence in the diagnostic process of NAFLD,…”

mentioning

confidence: 99%

SHBG as a Marker of NAFLD and Metabolic Impairments in Women Referred for Oligomenorrhea and/or Hirsutism and in Women With Sexual Dysfunction

et al. 2021

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“…( 206 ) Among women of Hispanic ethnicity, the prevalence of NAFLD is up to 70% of women with PCOS. ( 207 ) Thus, young women with NAFLD should be queried for PCOS symptoms ( 208 ) (e.g., menstrual irregularities, hirsutism, infertility), as PCOS requires specific therapeutic approaches. PCOS also appears to be associated with more severe histologic disease.…”

Section: Management Of Chronic Liver Diseases During Pregnancy and Lamentioning

confidence: 99%

Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases

et al. 2021

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“…Salva Pastor et al [ 28 ] settled a cross-sectional study aimed at determining the frequency of NAFLD in the Mexican population with PCOS and matched controls. This cross-sectional study included 98 women in the age range of 18–44 years old.…”

Section: Epidemiology and Predictors Of Nafld In Pcos Womenmentioning

confidence: 99%

Prevalence, Risk Factors, and Pathophysiology of Nonalcoholic Fatty Liver Disease (NAFLD) in Women with Polycystic Ovary Syndrome (PCOS)

et al. 2022

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Background: Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine disorders in women’s reproductive period of life. The presence of nonalcoholic fatty liver disease NAFLD, one of the leading causes of chronic liver disease in the Western world, is increased in women with PCOS. This review aims to present current knowledge in epidemiology, pathophysiology, diagnostics, and treatment of NAFLD in PCOS with an emphasis on the molecular basis of development of NAFLD in PCOS women. Methods: Authors investigated the available data on PCOS and NAFLD by a MEDLINE and Pub Med search during the years 1990–2021 using a combination of keywords such as “PCOS”, “NAFLD”, “steatohepatitis”, “insulin resistance”, “hyperandrogenaemia”, “inflammation”, “adipose tissue”, and “obesity”. Peer-reviewed articles regarding NAFLD and PCOS were included in this manuscript. Additional articles were identified from the references of relevant papers. Results: PCOS and NAFLD are multifactorial diseases, The development of NAFLD in PCOS women is linked to insulin resistance, hyperandrogenemia, obesity, adipose tissue dysfunction, and inflammation. There is the possible role of the gut microbiome, mitochondrial dysfunction, and endocannabinoid system in the maintenance of NAFLD in PCOS women. Conclusions: There is a need for further investigation about the mechanism of the development of NAFLD in PCOS women. New data about the molecular basis of development of NAFLD in PCOS integrated with epidemiological and clinical information could influence the evolution of new diagnostic and therapeutic approaches of NAFLD in PCOS.

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Polycystic ovary syndrome with feasible equivalence to overweight as a risk factor for non-alcoholic fatty liver disease development and severity in Mexican population

Cited by 26 publications

References 30 publications

SHBG as a Marker of NAFLD and Metabolic Impairments in Women Referred for Oligomenorrhea and/or Hirsutism and in Women With Sexual Dysfunction

SHBG as a Marker of NAFLD and Metabolic Impairments in Women Referred for Oligomenorrhea and/or Hirsutism and in Women With Sexual Dysfunction

Reproductive Health and Liver Disease: Practice Guidance by the American Association for the Study of Liver Diseases

Prevalence, Risk Factors, and Pathophysiology of Nonalcoholic Fatty Liver Disease (NAFLD) in Women with Polycystic Ovary Syndrome (PCOS)

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