Endocrine Abstracts

Background: Increased prevalence of abnormal aminotransferase levels and/or ultrasonographic evidence of hepatic steatosis have been found in women with polycystic ovary syndrome (PCOS), being more pronounced in overweight and obese patients. However, few data exist concerning the prevalence of PCOS in premenopausal women with nonalcoholic fatty liver disease (NAFLD).

Objective: To investigate the presence of PCOS in overweight and obese premenopausal women with NAFLD.

Patients/methods: Forty apparently healthy overweight and obese (BMI: 26.0–46.9 kg/m²) premenopausal women (age: 18–45 years) with a history of none or minimal alcohol consumption, were evaluated prospectively for the presence of NAFLD with abdominal ultrasonography and biochemical testing, after excluding causes of secondary liver disease. Insulin resistance was assessed by homeostasis model assessment (HOMA-IR). Hepatic steatosis was detected in 22/40 women, who were further studied for the presence of PCOS with hormonal evaluation and pelvic ultrasonography. Free androgen index (FAI) was calculated.

Results: PCOS was diagnosed in 10/22 patients with NAFLD (45.5%), according to the Androgen Excess Society criteria. Patients with NAFLD and PCOS compared to patients with NAFLD without PCOS were younger (29.3±6.5 vs 35.8±7.2 years, P=0.04), more obese (40.9±7.4 vs 34.4±5.6 kg/m², P=0.03), with an increased waist circumference (108.7±10.4 vs 95.3±15.9 cm, P=0.03) and had higher levels of serum testosterone (60.4±20.4 vs 33.1±13.6 ng/dl, P<0.01), lower SHBG levels (17.6±6.0 vs 30.5±6.3 nmol/l, P<0.001) and higher FAI values (12.7±5.2 vs 3.8±1.4, P<0.001).

Conclusions: These findings indicate an increased prevalence of PCOS in overweight and obese premenopausal women with NAFLD. Evaluation for PCOS should be considered in premenopausal NAFLD patients.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.