Polycystic Ovary Syndrome and Metabolic Syndrome: Clinical and Laboratory Findings and Non-Alcoholic Fatty Liver Disease Assessed by Elastography

Abstract

Objective To evaluate the association between polycystic ovary syndrome (PCOS) and metabolic syndrome (MetS), adding liver assessment through elastography and ultrasound, for correlation with non-alcoholic fatty liver disease (NAFLD). Metabolic syndrome occurs in ∼ 43% of women with PCOS, and NAFLD is the hepatic expression of MetS.

Methods One hundred women, 50 with PCOS and 50 controls, matched by age (18–35 years) and body mass index (BMI) were included, restricted to patients with overweight and obesity grade 1, at the Assis Chateaubrian Maternity School, Universidade Federal do Ceará, Brazil. For the diagnosis of PCOS, we adopted the Rotterdam criteria, and for the diagnosis of MetS, the criteria of the National Cholesterol Education Program (NCEP/ATP III). Hepatic elastography and ultrasound were performed to assess liver stiffness and echotexture, respectively.

Results The average ages were 29.1 (±5.3) and 30.54 (±4.39) years, for the PCOS and the control group, respectively. Patients with PCOS had a risk 4 times higher of having MetS, odds ratio (95% confidence interval) = 4.14, than those in the control group. Women with PCOS had higher average of abdominal circumference (100.9 ± 9.08 cm vs 94.96 ± 6.99 cm) and triglycerides (162 ± 54.63 mg/dL vs 137.54 ± 36.91 mg/dL) and lower average of HDL cholesterol (45.66 ± 6.88 mg/dL vs 49.78 ± 7.05 mg/dL), with statistically significant difference. Hepatic steatosis was observed on ultrasound in women with PCOS; however, with no statistically significant difference. There was no change to NAFLD at elastography in any group.

Conclusion Women with PCOS had 4-fold higher frequency of MetS and more hepatic steatosis, with no statistically significant difference. There was no change in liver stiffness between the groups at elastography. The results can be extended only to populations of overweight and obesity grade 1, with PCOS or not. They cannot be generalized to other untested groups.

Resumo

Objetivo Avaliar a associação entre a síndrome do ovário policístico (SOP) e a síndrome metabólica (SM), agregando avaliação do fígado por elastografia e ultrassonografia, para correlação com doença hepática gordurosa não alcoólica (DHGNA). A SM ocorre em cerca de 43% das mulheres com SOP, e DHGNA é a expressão hepática da SM.

Métodos Foram incluídas 100 mulheres, pareadas por idade (18–35 anos) e índice de massa corporal (IMC), 50 com SOP e 50 controles com sobrepeso e obesidade grau I, na Maternidade-Escola Assis Chateaubriand, Brasil. Para o diagnóstico de SOP, adotamos os critérios de Rotterdam e, para o diagnóstico de SM, os critérios do National Cholesterol Education Program (NCEP/ATP III). Elastografia hepática e ultrassonografia foram realizadas para avaliar a rigidez e a ecotextura do fígado, respectivamente.

Resultados As médias de idade foram de 29,1 (±5,3) e 30,54 (±4,39) anos para os grupos SOP e controle, respectivamente. Pacientes com SOP apresentaram risco 4 vezes maior de SM do que aquelas no grupo controle [[razão de chances (intervalo de confiança de 95%) = 4,14]. Mulheres com SOP tiveram maior média de circunferência abdominal (100,9 ± 9,08cm vs 94,96 ± 6,99 cm) e triglicérides (162 ± 54,63 mg/dL vs 137,54 ± 36,91 mg/dL) e menor média de colesterol HDL (45,66 ± 6,88 mg/dL vs 49,78 ± 7,05 mg/dL), com diferença estatisticamente significativa. Esteatose hepática foi observada em ultrassonografias de mulheres com SOP, porém sem diferença estatisticamente significativa. Não houve mudança para DHGNA na elastografia em nenhum dos grupos.

Conclusão Mulheres com SOP tiveram frequência quatro vezes maior de SM e mais esteatose hepática, sem diferença estatisticamente significativa. Não houve mudança na rigidez do fígado entre os grupos na elastografia. Os resultados podem ser estendidos apenas a populações com sobrepeso e obesidade grau 1, com SOP ou não. Eles não podem ser generalizados para outros grupos não testados.

Keywords

elastography - ultrasonography - polycystic ovaries - metabolic syndrome - obesity

Palavras-chave

elastografia - ultrassonografia - ovários policísticos - síndrome metabólica - obesidade

Collaborations

All of the authors contributed with the project and data interpretation, the writing of the article, the critical review of the intellectual content, and with the final approval of the version to be published.

Publication History

Received: 14 April 2021

Accepted: 20 September 2021

Article published online:
16 May 2022

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