Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome

doi:10.3748/wjg.v26.i44.7046

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 26, Issue 44

This Article

Academic Content and Language Evaluation of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (7912)

All Articles published online

The chart showing PDF series, WORD series, HTML series, Figures (1-5) series, Tables (1-3) series.

Item

Count

PDF

415

WORD

153

HTML

4735

Figures (1-5)

354

Tables (1-3)

282

Sum=5939

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

597

Download

1376

Sum=1973

Nov 28, 2020 (publication date) through Dec 26, 2024

Times Cited of This Article

Times Cited (18)

Journal Information of This Article

Publication Name

World Journal of Gastroenterology

ISSN

1007-9327

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

World J Gastroenterol. Nov 28, 2020; 26(44): 7046-7060
Published online Nov 28, 2020. doi: 10.3748/wjg.v26.i44.7046

Table 1 Demographic, clinical, biochemical, and pharmacological characteristics of the study population (n = 101) and univariate analyses by outcome status, that is presence of nonalcoholic fatty liver disease

Variable	Total cohort (n = 101)	NAFLD (n = 40)	No NAFLD (n = 61)
Age (yr)	36.3 (4.8)	36.1 (5.6)	36.4 (4.3)
PCOS duration (yr)	7.0 (4.1)	7.4 (4.4)	6.8 (3.9)
Regular physical exercise (%)	20 (19.8)	8 (20.0)	12 (19.7)
ASCVD risk (lifetime)	0.28 (0.12)	0.31 (0.11)^a	0.26 (0.13)^a
Metabolic factors
Diabetes (%)	18 (17.8)	12 (30.0)^a	6 (9.8)^a
Hypertension (%)	6 (5.9)	1 (2.5)	5 (8.2)
Waist circumference (cm)	101.1 (12.3)	107.8 (11.1)^b	96.7 (11.1)^b
BMI (Kg/m²)	27.6 (5.0)	30.6 (4.5)^b	25.7 (4.4)^b
Medications
Metformin (%)	32 (31.7)	20 (50.0)^a	12 (19.7)^a
Steroids contraceptive (%)	5 (4.9)	2 (5.0)	3 (4.9)
Statin (%)	5 (4.9)	5 (12.5)	0
Biochemical parameters
Platelet count (10⁹/L)	271.9 (59.5)	271.9 (54.7)	271.9 (62.9)
AST (IU/L)	18.6 (11.8)	23.5 (17.2)^b	15.3 (3.9)^b
ALT (IU/L)	21.7 (18.7)	30.9 (25.7)^b	15.7 (8.0)^b
GGT (IU/L)	21.4 (19.1)	24.8 (16.8)	19.3 (20.4)
Total bilirubin (µmol/L)	9 (2.9)	9.8 (3.6)^a	8.5 (2.2)^a
Albumin (mg/L)	43.0 (2.9)	42.9 (3.0)	43.0 (2.8)
HOMA-IR	3.2 (2.9)	4.5 (3.3)^b	2.4 (2.2)^b
HbA1c (%)	6.4 (1.8)	6.9 (2.1)^b	5.6 (0.6)^b
Total cholesterol (mmol/L)	4.5 (1.0)	4.5 (1.0)	4.5 (0.9)
HDL cholesterol (mmol/L)	1.1 (0.3)	1.1 (0.3)^a	1.2 (0.3)^a
LDL cholesterol (mmol/L)	2.7 (0.8)	2.6 (0.9)	2.7 (0.7)
Triglycerides (mmol/L)	1.5 (1.2)	1.8 (1.0)	1.4 (1.3)
Creatinine (mmol/L)	56.8 (10.1)	55.2 (8.9)	57.9 (10.8)
TSH	2.6 (2.7)	2.6 (2.5)	2.5 (2.8)
Total testosterone (nmol/L)	1.6 (0.7)	1.8 (0.8)	1.6 (0.6)
SHBG (nmol/L)	32.2 (20.6)	22.4 (9.7)^b	39.1 (23.3)^b
FAI	3.6 (3.7)	5.4 (4.6)^b	2.4 (2.1)^b
CRP (mg/L)	5.3 (4.9)	6.9 (6.2)^a	4.3 (3.5)^a
Non-invasive tests for NAFLD and liver fibrosis
CAP (dB/m)	266.9 (63.0)	326.9 (30.5)	227.5 (45.1)
LSM (kPa)	4.9 (1.9)	5.7 (2.2)^b	4.4 (1.4)^b
APRI	0.18 (0.15)	0.23 (0.21)^a	0.15 (0.07)^a
FIB-4	0.6 (0.2)	0.60 (0.3)	0.6 (0.2)
NAFLD Fibrosis Score	-2.9 (1.2)	-2.5 (1.3)^a	-3.1 (1.1)^a
HSI	38.3 (5.7)	40.8 (6.7)^b	36.6 (4.2)^b

Continuous variables are expressed as mean (standard deviation) and categorical variables as numbers (%).

^aP < 0.05.

^bP < 0.001.

The P values refer to t test or χ² test between patients with the outcome (nonalcoholic fatty liver disease or significant liver fibrosis) and those without the outcome. ALT: Alanine aminotransferase; APRI: Aspartate aminotransferase-to-platelet ratio index; ASCVD: Atherosclerotic cardiovascular disease; AST: Aspartate aminotransferase; BMI: Body mass index; dB/m: Decibels per meter; CAP: Controlled association parameter; CRP: C-reactive protein; FAI: Free androgen index; FIB-4: Fibrosis-4 score; GGT: Gamma-glutamyl transpeptidase; HbA1c: Glycosylated hemoglobin; HDL: High-density lipoprotein; HOMA-IR: Homeostasis model for assessment of insulin resistance; HSI: Hepatic steatosis index; IU: International unit; LDL: Low-density lipoprotein; LSM: Liver stiffness measurement; NAFLD: Nonalcoholic fatty liver disease; TSH: Thyroid-stimulating hormone.

Table 2 Demographic, clinical and biochemical characteristics of patients with significant liver fibrosis (n = 7)

	PCOS duration (yr)	HOMA-IR	BMI (Kg/m²)	ALT (IU/L)	Triglycerides (mmol/L)	FAI	CAP (dB/m)
Patient 1	10	3.2	31.8	62	0.93	3.1	317
Patient 2	4	1.4	26.2	12	0.91	3.0	186
Patient 3	6	10.9	30.1	88	1.36	5.9	372
Patient 4	13	2.8	28.2	20	0.91	6.3	298
Patient 5	6	5.9	31.2	78	1.66	8.0	346
Patient 6	8	7.9	36.4	101	1.37	3.1	386
Patient 7	13	5.6	20.2	31	2.4	13.9	325

ALT: Alanine aminotransferase; BMI: Body mass index; dB/m: Decibels per meter; CAP: Controlled association parameter; FAI: Free androgen index; HOMA-IR: Homeostasis model for assessment of insulin resistance; PCOS: Polycystic ovary syndrome.

Table 3 Multivariate analysis of factors associated with nonalcoholic fatty liver disease

CAP cut-off 288 dB/m
Variable	Unadjusted OR	aOR
PCOS duration (per yr)	1.03 (0.94-1.14)	1.04 (0.92-1.17)
BMI (per Kg/m²)	1.31 (1.16-1.48)^b	1.31 (1.13-1.52)^b
HOMA-IR (per unit)	1.42 (1.14-1.78)^a	1.13 (0.90-1.41)
Hyperandrogenism (yes vs no)	3.68 (1.37-9.83)^a	5.32 (1.56-18.17)^a
Elevated ALT (yes vs no)	5.14 (1.87-14.12)^a	3.54 (1.10-11.47)^a
CAP cut-off 302 dB/m
Variable	Unadjusted OR	aOR
PCOS duration (per yr)	0.81 (0.33-2.00)	0.94 (0.83-1.07)
BMI (per Kg/m²)	1.12 (1.06-1.18)^b	1.33 (1.14-1.55)^b
HOMA-IR (per unit)	1.39 (1.14-1.70)^a	1.18 (0.95-1.46)
Hyperandrogenism (yes vs no)	1.28 (1.10-1.48)^a	3.54 (1.00-12.57)^a
Elevated ALT (yes vs no)	1.93 (1.32-2.84)^a	2.55 (0.80-8.14)

Odds ratios and 95% confidence intervals are shown for each variable analyzed in univariate and multivariate logistic regression analysis.

^aP < 0.05.

^bP < 0.001.

CAP: Controlled attenuation parameter; FAI: Free androgen index; HOMA-IR: Homeostasis model for assessment of insulin resistance; IU: International unit; aOR: Adjusted odds ratio; NAFLD: Nonalcoholic fatty liver disease; PCOS: Polycystic ovary syndrome.

Citation: Shengir M, Krishnamurthy S, Ghali P, Deschenes M, Wong P, Chen T, Sebastiani G. Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome. World J Gastroenterol 2020; 26(44): 7046-7060
URL: https://www.wjgnet.com/1007-9327/full/v26/i44/7046.htm
DOI: https://dx.doi.org/10.3748/wjg.v26.i44.7046