Liver Disease May Accompany PCOS in Women


CHICAGO — Women with polycystic ovary syndrome can have fairly advanced liver disease, Dr. Tracy L. Setji of Duke University, Durham, N.C., and colleagues said in a poster presentation at the annual meeting of the American Association of Clinical Endocrinologists.

At a university endocrinology clinic, charts were reviewed retrospectively for 275 PCOS patients with oligomenorrhea and clinical or biochemical evidence of hyperandrogenism.

Of these, 200 had no other causes of irregular menses and drank less than one alcoholic beverage daily. Aspartate aminotransferase and alanine aminotransferase levels greater than 60 U/L were seen in 15%. Patients with elevated aminotransferase levels had lower median HDL cholesterol levels (41 mg/dL vs. 50 mg/dL), higher median triglycerides (174 mg/dL vs. 129 mg/dL), and higher median fasting insulin (21 μIU/mL vs. 12 μIU/mL), compared with patients without elevated aminotransferase levels.

Liver biopsies were performed in six women with persistently high aminotransferase levels, and they were diagnosed with nonalcoholic steatohepatitis (NASH) with fibrosis. These patients had lower median HDL levels and higher median triglyceride and fasting insulin levels than did patients who did not undergo biopsy.

The study was limited by the self-reporting of alcohol consumption.

Additionally, normal liver enzyme values do not exclude the presence of liver disease, including NASH, the investigators said.

“The young age of many women with polycystic ovary syndrome and the relatively advanced stage of NASH seen on the biopsies of our patients suggest the possibility of significant risk for long-term complications from liver disease,” the authors concluded.

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