Endocrine Abstracts

Introduction

Non-alcoholic liver fatty disease is one of the metabolic consequences found in patients followed for hyperandrogenia, especially those with polycystic ovary syndrome. Studies have suggested that hyperandrogenia is considered as an additional risk factor in synergy with obesity and insulin resistance in the development of non-alcoholic liver fatty disease. The aim of our work was to study the prevalence of non-alcoholic liver fatty in patients consulting for hyperandrogenia and to identify these predicting factors.

Material and methods

This is a retrospective descreptive study involving 98 patients followed for hyperandrogenia in Endocrinology-Diabetology-and-Nutrition Department of the Mohammed VI University Hospital Center of Oujda, Morocco. All patients were provided with a complete clinical examination and laboratory analysis, and the abdominal ultrasound was performed in only 25 patients.

Results

We collected 98 patients having a hyperandrogenia with an average age at 24.6 ± 6.2 years old. Abdominal ultrasound showed non-alcoholic liver fatty in 8 patients, varying in age from 23 to 41 years with an average of 30.5 ± 6.3 years old. The mean BMI of these patients was elevated above 32.1 ± 10.2 kg/m², obesity was noted in 50% of cases, and overweight in 12.5%. Abdominal obesity was objectivated in 75% of cases, with an increased average waist circumference at 110.7 ± 28.4 cm. Insulin resistance was present in 50% of cases. Dyslipidemia was reported in all patients, with hypoHDlemia in 87.5% of patients, hypertriglyceridemia in 25% and hypercholesterolemia in 12.5%. 50% of patients with non-alcoholic liver fatty had polycystic ovary syndrome, 37.5% had idiopathic hirsutism and 12.5% had Cushing disease.

Discussion–conclusion

The present study shows a high prevalence of non-alcoholic liver fatty (NALF) in overweight and obese patients with lipid and carbohydrate metabolism disorders notably those with insulin resistance, especially patients followed for polycystic ovary syndrome (PCOS). This is in agreement with the data reported in the literature, which find an increased prevalence of NALF in women with PCOS. Further, that obesity and insulin resistance (IR) seem to be the main contributing factors to NALF. In particular, IR is linked to impaired suppression of lipolysis in adipose tissue, leading to higher levels of free fatty acids in the liver, and steatosis. Hence the interest of systematic screening for non-alcoholic liver fatty at diagnosis and during follow-up, in patients followed for hyperandrogenia, especially those with PCOS, to avoid the risk of progression to cirrhosis or even hepatocellular carcinoma in the absence of early and adequate management.