Association between Poly Cystic Ovaries and Non-Alcoholic Fatty Liver Disease in Young Females on Ultrasonography : Association between PCOS and NAFLD

Tehreem  Malik; Akash  John; Abid  Ali; Muhammad Ahmad  Naeem

doi:10.54393/pjhs.v4i09.954

Authors

Tehreem Malik University Institute of Radiological Sciences & Medical Imaging Technology, The University of Lahore, Gujrat, Pakistan
Akash John University Institute of Radiological Sciences & Medical Imaging Technology, The University of Chenab, Gujrat, Pakistan
Abid Ali University Institute of Radiological Sciences & Medical Imaging Technology, The University of Chenab, Gujrat, Pakistan
Muhammad Ahmad Naeem University Institute of Radiological Sciences & Medical Imaging Technology, The University of Chenab, Gujrat, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v4i09.954

Keywords:

Polycystic Ovaries, Fatty Liver Disease, Ultrasound, Obesity, Hypertension, Dyslipidemia

Abstract

PCOS and nonalcoholic fatty liver disease are both associated with the metabolic syndrome, which is characterized by central adiposity, hypertension, diabetes, and dyslipidemia. Objective: To determine the association between poly cystic ovaries and non-alcoholic fatty liver disease in young females. Methods: In this cross-sectional study at Chughtai Medical Center in Lahore, 272 patients with polycystic ovaries and fatty liver disease were selected. Utilizing a convex abdominal instrument with a frequency range of 3-5 MHz, the Toshiba Nemio 17 was utilized. Results: In this study, 74 out of 272 female patients diagnosed with PCOS also had fatty liver, highlighting a significant association (p-value = 0.025). Notably, within the 17-25 age group, 45 to 46 patients exhibited fatty liver, suggesting a link between PCOS and fatty liver in younger individuals experiencing hormonal issues. Conclusions: This study demonstrates association between polycystic ovary syndrome in adolescent females and with nonalcoholic fatty liver disease. The findings support the notion that PCOS is more prevalent in individuals with NAFLD.

References

Swaroop A, Jaipuriar AS, Gupta SK, Bagchi M, Kumar P, Preuss HG, et al. Efficacy of a novel fenugreek seed extract (Trigonella foenum-graecum, FurocystTM) in polycystic ovary syndrome (PCOS). International Journal of Medical Sciences. 2015 Oct; 12(10): 825-31. doi: 10.7150/ijms.13024. DOI: https://doi.org/10.7150/ijms.13024

Obermayer-Pietsch B, Trummer C, Schwetz V, Schweighofer N, Pieber T. Genetics of insulin resistance in polycystic ovary syndrome. Current Opinion in Clinical Nutrition & Metabolic Care. 2015 Jul; 18(4): 401-6. doi: 10.1097/MCO.0000000000000190. DOI: https://doi.org/10.1097/MCO.0000000000000190

Blank SK, Helm KD, McCartney CR, Marshall JC. Polycystic ovary syndrome in adolescence. Annals of the New York Academy of Sciences. 2008 Jun; 1135(1): 76-84. doi: 10.1196/annals.1429.005. DOI: https://doi.org/10.1196/annals.1429.005

Oktem O and Oktay K. The ovary: anatomy and function throughout human life. Annals of the New York Academy of Sciences. 2018 Apr; 1127(1): 1-9. doi: 10.1196/annals.1434.009. DOI: https://doi.org/10.1196/annals.1434.009

Palomba S, Santagni S, Falbo A, La Sala GB. Complications and challenges associated with polycystic ovary syndrome: current perspectives. International Journal of Women's Health. 2015 Jul; 7: 745-63. doi: 10.2147/IJWH.S70314. DOI: https://doi.org/10.2147/IJWH.S70314

Rotterdam ESHRE/ASRM‐Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long‐term health risks related to polycystic ovary syndrome (PCOS). Human Reproduction. 2004 Jan; 19(1): 41-7. doi: 10.1093/humrep/deh098. DOI: https://doi.org/10.1093/humrep/deh098

Carmina E. Diagnosis of polycystic ovary syndrome: from NIH criteria to ESHRE-ASRM guidelines. Minerva Ginecologica. 2004 Feb; 56(1): 1-6.

Wolf WM, Wattick RA, Kinkade ON, Olfert MD. Geographical prevalence of polycystic ovary syndrome as determined by region and race/ethnicity. International Journal of Environmental Research and Public Health. 2018 Nov; 15(11): 2589. doi: 10.3390/ijerph15112589. DOI: https://doi.org/10.3390/ijerph15112589

Qin JZ, Pang LH, Li MJ, Fan XJ, Huang RD, Chen HY. Obstetric complications in women with polycystic ovary syndrome: a systematic review and meta-analysis. Reproductive Biology and Endocrinology. 2013 Dec; 11(1): 56. doi: 10.1186/1477-7827-11-56. DOI: https://doi.org/10.1186/1477-7827-11-56

Moran C, Tena G, Moran S, Ruiz P, Reyna R, Duque X. Prevalence of polycystic ovary syndrome and related disorders in mexican women. Gynecologic and Obstetric Investigation. 2010 Jan; 69(4): 274-80. doi: 10.1159/000277640. DOI: https://doi.org/10.1159/000277640

Juza RM and Pauli EM. Clinical and surgical anatomy of the liver: a review for clinicians. Clinical Anatomy. 2014 Jul; 27(5): 764-9. doi: 10.1002/ca.22350. DOI: https://doi.org/10.1002/ca.22350

Nidhi R, Padmalatha V, Nagarathna R, Amritanshu R. Prevalence of polycystic ovarian syndrome in Indian adolescents. Journal of Pediatric and Adolescent Gynecology. 2011 Aug; 24(4): 223-7. doi: 10.1016/j.jpag.2011.03.002. DOI: https://doi.org/10.1016/j.jpag.2011.03.002

Yildiz BO, Yarali H, Oguz H, Bayraktar M. Glucose intolerance, insulin resistance, and hyperandrogenemia in first degree relatives of women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 2013 May; 88(5): 2031-6. doi: 10.1210/jc.2002-021499. DOI: https://doi.org/10.1210/jc.2002-021499

Michelotti GA, Machado MV, Diehl AM. NAFLD, NASH and liver cancer. Nature reviews Gastroenterology & Hepatology. 2013 Nov; 10(11): 656-65. doi: 10.1038/nrgastro.2013.183. DOI: https://doi.org/10.1038/nrgastro.2013.183

Yang JD, Kim B, Sanderson SO, Sauver JL, Yawn BP, Pedersen RA, et al. Hepatocellular carcinoma in olmsted county, Minnesota, 1976-2008. Mayo Clinic Proceedings. 2012 Jan; 87(1): 9-16. doi: 10.1016/j.mayocp.2011.07.001. DOI: https://doi.org/10.1016/j.mayocp.2011.07.001

Legro RS, Castracane VD, Kauffman RP. Detecting insulin resistance in polycystic ovary syndrome: purposes and pitfalls. Obstetrical & Gynecological Survey. 2014 Feb; 59(2): 141-54. doi: 10.1097/01.OGX.0000109523.25076.E2. DOI: https://doi.org/10.1097/01.OGX.0000109523.25076.E2

Cooney LG and Dokras A. Beyond fertility: polycystic ovary syndrome and long-term health. Fertility and Sterility. 2018 Oct; 110(5): 794-809. doi: 10.1016/j.fertnstert.2018.08.021. DOI: https://doi.org/10.1016/j.fertnstert.2018.08.021

Friedman SL, Neuschwander-Tetri BA, Rinella M, Sanyal AJ. Mechanisms of NAFLD development and therapeutic strategies. Nature Medicine. 2018 Jul; 24(7): 908-22. doi: 0.1038/s41591-018-0104-9. DOI: https://doi.org/10.1038/s41591-018-0104-9

Araújo AR, Rosso N, Bedogni G, Tiribelli C, Bellentani S. Global epidemiology of non‐alcoholic fatty liver disease/non‐alcoholic steatohepatitis: what we need in the future. Liver International. 2018 Feb; 38: 47-51. doi: 10.1111/liv.13643. DOI: https://doi.org/10.1111/liv.13643

Angulo P. Nonalcoholic fatty liver disease. New England Journal of Medicine. 2012 Apr; 346(16): 1221-31. doi: 10.1056/NEJMra011775. DOI: https://doi.org/10.1056/NEJMra011775

Brzozowska MM, Ostapowicz G, Weltman MD. An association between non‐alcoholic fatty liver disease and polycystic ovarian syndrome. Journal of Gastroenterology and Hepatology. 2019 Feb; 24(2): 243-7. doi: 10.1111/j.1440-1746.2008.05740.x. DOI: https://doi.org/10.1111/j.1440-1746.2008.05740.x

Faisal A, Gadallah AN, Zyiton A, Eskander A. Liver Affection in Polycystic Ovary Syndrome (PCOS). Medical Journal of Cairo University. 2012 Sep; 80(2): 117-22.

Brown AJ, Tendler DA, McMurray RG, Setji TL. Polycystic ovary syndrome and severe nonalcoholic steatohepatitis: beneficial effect of modest weight loss and exercise on liver biopsy findings. Endocrine Practice. 2015 Sep; 11(5): 319-24. doi: 10.4158/EP.11.5.319. DOI: https://doi.org/10.4158/EP.11.5.319

Targher G, Rossini M, Lonardo A. Evidence that non-alcoholic fatty liver disease and polycystic ovary syndrome are associated by necessity rather than chance: a novel hepato-ovarian axis? Endocrine. 2016 Feb; 51(2): 211-21. doi: 10.1007/s12020-015-0640-8. DOI: https://doi.org/10.1007/s12020-015-0640-8

Ramezani-Binabaj M, Motalebi M, Karimi-sari H, Rezaee-Zavareh MS, Alavian SM. Are women with polycystic ovarian syndrome at a high risk of non-alcoholic Fatty liver disease; a meta-analysis. Hepatitis Monthly. 2014 Nov; 14(11): e23235. doi: 10.5812/hepatmon.23235. DOI: https://doi.org/10.5812/hepatmon.23235