SAN DIEGO — Nonalcoholic fatty liver disease is common in women with polycystic ovary syndrome, regardless of their body mass index, a retrospective analysis of 88 patients has shown.
Although the prevalence of nonalcoholic fatty liver disease in lean women in the general population ranges from 3% to 16%, the prevalence in lean women with polycystic ovary syndrome (PCOS) in this study was 39%.
“We expected [the association], but I think the degree of prevalence is surprising,” Sanjiv Kinkhabwala, M.D., of the division of endocrinology, diabetes, and bone diseases at Mount Sinai School of Medicine, New York, reported in a poster session at the annual meeting of the Androgen Excess Society.
He and his associate, Walter Futterweit, M.D., retrospectively evaluated 88 consecutive premenopausal women with PCOS seen between April and November 2004. The patients denied heavy alcohol use and known liver disease, and all had PCOS. Nonalcoholic fatty liver disease was diagnosed by prospective abdominal ultrasound.
The investigators grouped the women by body mass index (BMI), defining lean as having a BMI of less than 25 kg/m
Of the 88 women, 48 (55%) had nonalcoholic fatty liver disease. The prevalence of the disease among lean, overweight, and obese patients was 39%, 54%, and 70%, respectively.
Patients with fatty liver disease had higher median BMI, ALT level, insulin resistance (based on premetformin homeostatic assessment), and gamma-glutamyl transferase level, as well as a lower median fasting HDL cholesterol level, compared with women who did not have the disease.
Only 7 of the 48 patients with fatty liver disease (15%) had elevated liver chemistries. “Only checking the liver chemistries is insufficient,” he said. “In someone with a BMI of 25, one should do an ultrasound of the abdomen and pelvis.”