Diagnostic significance of clinical and laboratory indices in predicting non-alcoholic fatty liver disease during screening studies

Aim. To study the significance of clinical and laboratory non-invasive indexes along with the insulin resistance index when carrying out diagnostic assessment of non-alcoholic fatty liver disease (NAFLD) during screening examinations. Materials and methods. The study involved 348 employees working at oil-production enterprises. An ultrasound scanning of the liver was carried out to assess the criteria of NAFLD. The following indexes were calculated: fatty liver index (FLI), hepatic steatosis index (HSI), lipid accumulation products (LAP), and homeostasis model assessment of insulin resistance (HOMA1-IR). The prognostic significance of these indexes in relation to the probability of NAFLD diagnosis based on ultrasound data was studied using single-factor and multi-factor logistic regression models followed by ROC-analysis. Results. The FLI, HSI, and HOMA1-IR indexes in single-factor logistic regression models showed a high statistical significance when carrying out diagnostic assessment the NAFLD with good model calibration capability. The percentage of correct binary classification regards the presence/absence of NAFLD amounted to 82.4% for FLI, 79.7% for HSI, and 72.7% for HOMA1-IR (p0.001). According to the ROC-analysis, the area under the curve (AUC) by the NAFLD diagnostic assessment was 0.917 (95% CI 0.8890.945); 0.880 (95% CI 0.8460.915) and 0.849 (95% CI 0.7640.934), respectively. The multi-factor logistic regression model with the inclusion of FLI and HOMA1-IR 72.7% enabled us to achieve the correct binary classification in terms of NAFLD in 84.2% of cases. When it comes to the ROC-analysis, considering the probabilities predicted in the multi-factor logistic model as the test variable and NAFLD in ultrasound examination as the state variable, it was possible to set the value of AUC 0.933 (95% CI 0.8820.985). Conclusion. The studied clinical and laboratory indexes (FLI, HSI, HOMA1-IR) have a high diagnostic significance regarding NAFLD diagnosed using ultrasonographic criteria. The application of the proposed two-factor logistics model makes it possible to predict the presence of NAFLD when examining a large number of patients, without involving additional ultrasound diagnostics specialists in order to use medical resources rationally.

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Association of the SH2B1 rs7359397 Gene Polymorphism with Steatosis Severity in Subjects with Obesity and Non-Alcoholic Fatty Liver Disease

Nutrients ◽

10.3390/nu12051260 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1260 ◽

Cited By ~ 1

Author(s):

Nuria Perez-Diaz-del-Campo ◽

Itziar Abete ◽

Irene Cantero ◽

Bertha Araceli Marin-Alejandre ◽

J. Ignacio Monreal ◽

...

Keyword(s):

Logistic Regression ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Regression Models ◽

Risk Allele ◽

Alcoholic Fatty Liver ◽

Logistic Regression Models ◽

Lipidomic Analysis ◽

Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is a major cause of liver disease worldwide. Some genetic variants might be involved in the progression of this disease. The study hypothesized that individuals with the rs7359397 T allele have a higher risk of developing severe stages of NAFLD compared with non-carriers where dietary intake according to genotypes could have a key role on the pathogenesis of the disease. SH2B1 genetic variant was genotyped in 110 overweight/obese subjects with NAFLD. Imaging techniques, lipidomic analysis and blood liver biomarkers were performed. Body composition, general biochemical and dietary variables were also determined. The SH2B1 risk genotype was associated with higher HOMA-IR p = 0.001; and Fatty Liver Index (FLI) p = 0.032. Higher protein consumption (p = 0.028), less mono-unsaturated fatty acid and fiber intake (p = 0.045 and p = 0.049, respectively), was also referred to in risk allele genotype. Lipidomic analysis showed that T allele carriers presented a higher frequency of non-alcoholic steatohepatitis (NASH) (69.1% vs. 44.4%; p = 0.006). In the genotype risk group, adjusted logistic regression models indicated a higher risk of developing an advanced stage of NAFLD measured by FLI (OR 2.91) and ultrasonography (OR 4.15). Multinomial logistic regression models showed that risk allele carriers had higher liver fat accumulation risk (RRR 3.93) and an increased risk of NASH (RRR 7.88). Consequently, subjects carrying the T allele were associated with a higher risk of developing a severe stage of NAFLD. These results support the importance of considering genetic predisposition in combination with a healthy dietary pattern in the personalized evaluation and management of NAFLD.

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The relation between serum adipose differentiation-related protein and non-alcoholic fatty liver disease in type 2 diabetes mellitus

Therapeutic Advances in Endocrinology and Metabolism ◽

10.1177/2042018820969025 ◽

2020 ◽

Vol 11 ◽

pp. 204201882096902

Author(s):

Huaying Fan ◽

Hongjie Diao ◽

Yan Lu ◽

Jing Xie ◽

Xingbo Cheng

Keyword(s):

Logistic Regression ◽

Fatty Liver Disease ◽

Regression Models ◽

Related Protein ◽

Alcoholic Fatty Liver ◽

Logistic Regression Models ◽

Group I ◽

Adipose Differentiation ◽

Alcoholic Fatty Liver Disease

Background: Adipose differentiation-related protein (ADRP) is an adipokine. In vitro and animal studies have verified the role of ADRP in lipid metabolism and non-alcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the interaction between levels of ADRP and NAFLD in type 2 diabetes mellitus (T2DM). Methods: Cross-sectional design. A total of 142 patients with T2DM were assigned to NAFLD (Group-I) and non-NAFLD (Group-II). Anthropometric data were collected. Serum ADRP levels and biochemical parameters were also determined. t test or χ2 test was conducted to compare the data between two groups. Receiver operating characteristic (ROC) curve analysis and logistic regression models were used to assess the interaction between ADRP levels and NAFLD in T2DM. Pearson correlation analysis and linear regression model were used to assess the correlations between serum ADRP levels and other parameters. Results: The serum ADRP level was higher in Group-I than in Group-II. Further, binary logistic regression models demonstrated that ADRP was an independent risk factor related to NAFLD in patients with T2DM. Moreover, as the ADRP level elevated across its tertiles, the percentage of NAFLD in T2DM increased. Multivariate logistic regression models demonstrated that the odds ratio of NAFLD was 8.831 in the highest tertile of ADRP, after adjustment for potential confounders. Area under THE ROC curve of ADRP for predicting the presence of NAFLD in T2DM was 0.738. Finally, multiple stepwise regression analysis indicated that age, waist circumference (WC), homeostasis model assessment of insulin resistance index (HOMA-IR) and triglyceride (TG) were independent factors associated with ADRP levels. Conclusion: High serum ADRP level may be used as an independent risk factor for NAFLD in T2DM. The expression of ADRP may be affected by age, WC, HOMA-IR and TG.

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Polymorphisms 677C > T and 1298A > C in the MTHFR gene and homocysteine levels in patients with non-alcoholic fatty liver disease as a component of the ontological model

Modern Gastroenterology ◽

10.30978/mg-2021-5-21 ◽

2021 ◽

Author(s):

N. A. Nosko ◽

O. M. Rud

Keyword(s):

Logistic Regression ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Mthfr Gene ◽

Scientific Data ◽

Multiple Logistic Regression ◽

Alcoholic Fatty Liver ◽

Significant Difference ◽

Alcoholic Fatty Liver Disease

Objective — to systematize literature data on the presence of 677C > T and 1298A > C polymorphisms in the MTHFR gene and homocysteine levels in patients with non‑alcoholic fatty liver disease (NAFLD); to calculate the frequencies 677C > T and 1298A > C polymorphisms combinations in the MTHFR gene and their impact on NAFLD development; to compare homocysteine levels in patients with and without NAFLD. Materials and methods. The analysis has been performed for the results of investigation of 49 patients, from them 17 subjects with NAFLD and 32 without it. Clinical, laboratory, statistical and ontological methods were used in the study. The MTHFR 677C > T and MTHFR 1298A > C polymorphisms in the MTHFR gene were investigated with the use of real time polymerase chain reaction (RT‑PCR) technique. Homocysteine levels were determined with chemiluminescent immunoassay with reference values 3.7 — 13.9 µmol/L. Multiple logistic regression method was used to evaluate the effects 677C > T and 1298A > C polymorphisms in the MTHFR gene on NAFLD development. Results. The variant of combination of 667С/С/1298А/А polymorphisms in the MTHFR gene (absence of mutation) was reveled in 6 (12 %) persons, that showed a widespread prevalence of variants with the presence of mutations. The correlation between variants of 677C > T and 1298A > C polymorphism in the MTHFR gene has been established (r = 0.429; p < 0.05). The results of multiple logistic regression demonstrated absence of the significant effects of 677C > T and 1298A > C polymorphisms in the MTHFR gen on NAFLD development (p > 0.05). Comparison of the homocysteine levels in patients with and without NAFLD didn’t reveal significant difference (р > 0.05), as well as comparison in the groups with combinations of 677C > T and 1298А > С polymorphisms in the MTHFR gen (р > 0.05). This can be explained by the fact that NAFLD group consisted of manly young patients without hypertension, type 2 diabetes mellitus and severe liver fibrosis. Conclusions. Ontological systematization of the scientific data on NAFLD revealed that 677C > T and 1298A > C polymorphisms in the MTHFR gen are pathogenetically associated with the significant increase in homocysteine levels as a marker of cardiovascular pathology. Giving the multifactorial nature of hyperhomocysteinemia and wide spread of 677C > T and 1298A > C polymorphisms in the MTHFR gen in population, it seems to be impractical to use genetic investigations for MTHFR gen polymorphism in NAFLD patients routinely, but only for the purpose of differential diagnosis of hyperhomocysteinemia.

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The role of anthropometric indices in the prediction of non-alcoholic fatty liver disease in the PERSIAN Guilan Cohort study (PGCS)

Journal of Medicine and Life ◽

10.25122/jml-2018-0031 ◽

2018 ◽

Vol 11 (3) ◽

pp. 194-202 ◽

Cited By ~ 2

Author(s):

Roya Mansour-Ghanaei ◽

◽

Fariborz Mansour-Ghanaei ◽

Mohammadreza Naghipour ◽

Farahnaz Joukar ◽

...

Keyword(s):

Logistic Regression ◽

Cohort Study ◽

Liver Disease ◽

Fatty Liver ◽

Significant Relationship ◽

Fatty Liver Disease ◽

Abdominal Ultrasound ◽

Anthropometric Indices ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

Introduction:Non-alcoholic fatty liver disease (NAFLD) is an obesity-associated health problem that causes other liver diseases for the patient. Four anthropometric indices: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were analyzed as NAFLD predictors in the present study.Methods:From the total number of individuals who referred to the PERSIAN Guilan Cohort study (PGCS) located in the north of Iran during the period of study, a total of 960 people were enrolled in the present study. NAFLD was diagnosed using through an abdominal ultrasound exam. Height, weight, WC, BMI, WHR and WHtR were later calculated. Chi-square, ANOVA and logistic regression analyses were used to analyze the risk factors.Results:Out of the 960 individuals who were enrolled in the study, 597 (62.2%) were male and 363 (37.8%) were female (with an average age of 47.21 ± 7.29 years). There was a significant relationship between weight and NAFLD (P<0.001). There was also a significant relationship between BMI (OR= 8.41; 95% CI = 5.59–12.75), WC (OR= 2.67; 95% CI = 2.05–3.48), WHR (OR= 3.84; 95% CI = 2.26–6.52), WHtR (OR= 28.53; 95% CI = 6.94–117.31) and NAFLD (P<0.001). The results of the logistic regression analysis showed that WHtR, BMI and WC were effective predictors for the risk of NAFLD while WHtR played a more important role in the prediction of NAFLD.Conclusion:Anthropometric indices, especially WHtR, as a simple screening tool, seem to be an important criterion for the detection of NAFLD.

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Effects of sleep quality on non-alcoholic fatty liver disease: a cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2020-039947 ◽

2020 ◽

Vol 10 (10) ◽

pp. e039947

Author(s):

Atsushi Takahashi ◽

Yukio Anzai ◽

Masahito Kuroda ◽

Masae Kokubun ◽

Yuichiro Kondo ◽

...

Keyword(s):

Logistic Regression ◽

Regression Analysis ◽

Liver Disease ◽

Sleep Quality ◽

Fatty Liver ◽

Logistic Regression Analysis ◽

Fatty Liver Disease ◽

Medication Use ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

BackgroundThe effects of sleep quality on the risk of developing non-alcoholic fatty liver disease (NAFLD) remain uncertain. The purpose of this study was to clarify the association between sleep quality and NAFLD.MethodsThe data of 4828 participants who underwent health check-ups at four hospitals were analysed. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI), which comprised seven elements scored from 0 to 3. The global PSQI score and the score for each element were compared between NAFLD and non-NAFLD groups separately by sex. Logistic regression analysis was performed to determine the association between NAFLD and each PSQI score.ResultsIn both men and women, the mean PSQI score for sleep medication use was significantly higher in non-NAFLD than in NAFLD. With regard to sleep medication use in men, the OR (95% CI) for NAFLD was lower with a score of 3 (OR 0.60, 95% CI 0.38–0.95) than with a score of 0 on multivariate logistic regression analysis adjusted for age, smoking habits and physical activity. The OR for NAFLD based on daytime dysfunction was also higher with a score of 3 than with a score of 0 in both men (OR 2.82, 95% CI 1.39–5.75) and women (OR 2.08, 95% CI 1.10–3.92). After adjustment for body mass index, the sleep latency scores in men and daytime dysfunction in women were associated with NAFLD.ConclusionSleep quality was associated with NAFLD, and there were sex differences.

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The significance of hepatic transaminases and ultrasound in the diagnosis of non-alcoholic fatty liver disease

Regulatory Mechanisms in Biosystems ◽

10.15421/021815 ◽

2018 ◽

Vol 9 (1) ◽

pp. 105-111

Author(s):

Y. M. Stepanov ◽

N. V. Nedzvetskaya ◽

V. B. Yagmur ◽

I. S. Konenko

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Liver Steatosis ◽

Splenic Vein ◽

Coarse Grained ◽

Response To Treatment ◽

Diagnostic Significance ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease is characterized by fatty liver infiltration without any another common cause of steatosis (severe alcohol, drugs, etc.). Non-alcoholic fatty liver disease is associated with metabolic risk factors, which are diabetes type 2, dyslipidemia, obesity, and in some cases, it has a genetic predisposition as a main cause. The liver biopsy remains the “gold standard” for assessing the degree of steatosis, necrosis and liver fibrosis. However, non-invasive investigations, especially biochemical markers and visualization methods remain the first-line diagnostic analyses, as well as assessment of the response to treatment. In view of this, the aim of our research was to evaluate the validity of biochemical parameters of liver function and ultrasound in the diagnosis of non-alcoholic fatty liver disease. Patients diagnosed with non-alcoholic fatty liver disease were studied in this research Every patient underwent to both an examination and treatment in the Department of Liver and Pancreatic Diseases at the Institute of Gastroenterology, NAMS of Ukraine. All patients were exposed to ultrasound visualization of the abdominal organs, standard biochemical studies (content analyses of alanine aminotransferase, aspartate aminotransferase, total bilirubin and its fractions, activity of alkaline phosphatase, gammaglutamyltranspeptidase, X-lipoproteins, total protein, albumin, fibrinogen, international normalized ratio) were performed in the blood serum . Increased echogenicity of the liver and distal decrement of ultrasound, as the main ultrasonographic symptoms of liver steatosis, were determined with high incidence in all patients with non-alcoholic fatty liver disease. A number of symptoms (heterogeneity of the echo-structure of the liver of medium and coarse-grained nature, roundness of the lower edge of the liver, inequalities in the liver contour), the frequency of which is more closely related to the severity of inflammatory, as well as fibrotic changes, were observed more often in patients with non-alcoholic steatohepatitis and cirrhosis compared with steatosis. The deterioration in the visualization of small branches of the liver veins was determined as a result of the smoothness of the vascular pattern and its depletion. Moreover, the results showed an increment of the spleen volume, along with the enlargement of the splenic vein of patients with cirrhosis. All observed changes were considered as a component of portal hypertension and were induced with fibrotic transformation of the liver. The lack of correlation of the degree of fibrosis with the content of transaminases confirms the low diagnostic significance of these indicators. Nevertheless, the moderate direct correlation of the determined ultrasonographic indexes with degree of the fibrosis in the liver indicates the possibility of using this method for screening non-alcoholic fatty liver disease.

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The usefulness of obesity and lipid-related indices to predict the presence of Non-alcoholic fatty liver disease

Lipids in Health and Disease ◽

10.1186/s12944-021-01561-2 ◽

2021 ◽

Vol 20 (1) ◽

Author(s):

Guotai Sheng ◽

Song Lu ◽

Qiyang Xie ◽

Nan Peng ◽

Maobin Kuang ◽

...

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Roc Analysis ◽

Visceral Adiposity Index ◽

Male Population ◽

Female Population ◽

Alcoholic Fatty Liver ◽

Tyg Index ◽

Alcoholic Fatty Liver Disease

Abstract Background Conicity index, body-shape index, lipid accumulation product (LAP), waist circumference (WC), triglyceride, triglyceride-glucose (TyG) index, hepatic steatosis index (HSI), waist-to-height ratio (WHtR), TyG index-related parameters (TyG-WHtR, TyG-BMI, TyG-WC), body mass index (BMI), visceral adiposity index, triglyceride to high-density lipoprotein cholesterol ratio and body roundness index have been reported as reliable markers of non-alcoholic fatty liver disease (NAFLD). However, there is debate about which of the above obesity and lipid-related indices has the best predictive performance for NAFLD risk. Methods This study included 6870 female and 7411 male subjects, and 15 obesity and lipid-related indices were measured and calculated. NAFLD was diagnosed by abdominal ultrasound. The area under the curve (AUC) of 15 obesity and lipid-related indices were calculated by receiver operating characteristic (ROC) analysis. Results Among the 15 obesity and lipid-related indices, the TyG index-related parameters had the strongest association with NAFLD. ROC analysis showed that except for ABSI, the other 14 parameters had high predictive value in identifying NAFLD, especially in female and young subjects. Most notably, TyG index-related parameters performed better than other parameters in predicting NAFLD in most populations. In the female population, the AUC of TyG-WC for predicting NAFLD was 0.9045, TyG-BMI was 0.9084, and TyG-WHtR was 0.9071. In the male population, the AUC of TyG-WC was 0.8356, TyG-BMI was 0.8428, and TyG-WHtR was 0.8372. In addition, BMI showed good NAFLD prediction performance in most subgroups (AUC>0.8). Conclusions Our data suggest that TyG index-related parameters, LAP, HSI, BMI, and WC appear to be good predictors of NAFLD. Of these parameters, TyG index-related parameters showed the best predictive potential.

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Diagnosis of Fibrosis Using Blood Markers and Logistic Regression in Southeast Asian Patients With Non-alcoholic Fatty Liver Disease

Frontiers in Medicine ◽

10.3389/fmed.2021.637652 ◽

2021 ◽

Vol 8 ◽

Author(s):

Chao Sang ◽

Hongmei Yan ◽

Wah Kheong Chan ◽

Xiaopeng Zhu ◽

Tao Sun ◽

...

Keyword(s):

Logistic Regression ◽

Liver Disease ◽

Liver Biopsy ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Advanced Fibrosis ◽

Alcoholic Fatty Liver ◽

Nafld Fibrosis Score ◽

Glutamyl Transferase ◽

Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is one of the main causes of fibrosis. Liver biopsy remains the gold standard for the confirmation of fibrosis in NAFLD patients. Effective and non-invasive diagnosis of advanced fibrosis is essential to disease surveillance and treatment decisions. Herein we used routine medical test markers and logistic regression to differentiate early and advanced fibrosis in NAFLD patients from China, Malaysia, and India (n1 = 540, n2 = 147, and n3 = 97) who were confirmed by liver biopsy. Nine parameters, including age, body mass index, fasting blood glucose, presence of diabetes or impaired fasting glycemia, alanine aminotransferase, γ-glutamyl transferase, triglyceride, and aspartate transaminase/platelet count ratio, were selected by stepwise logistic regression, receiver operating characteristic curve (ROC), and hypothesis testing and were used for model construction. The area under the ROC curve (auROC) of the model was 0.82 for differentiating early and advanced fibrosis (sensitivity = 0.69, when specificity = 0.80) in the discovery set. Its diagnostic ability remained good in the two independent validation sets (auROC = 0.89 and 0.71) and was consistently superior to existing panels such as the FIB-4 and NAFLD fibrosis score. A web-based tool, LiveFbr, was developed for fast access to our model. The new model may serve as an attractive tool for fibrosis classification in NAFLD patients.

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Thyroid Function and Risk of Non-Alcoholic Fatty Liver Disease in Euthyroid Subjects

Annals of Hepatology ◽

10.5604/01.3001.0012.2112 ◽

2018 ◽

Vol 17 (5) ◽

pp. 0-10

Author(s):

Yiting Liu ◽

Wei Wang ◽

Xiaosong Yu ◽

Xingshun Qi

Keyword(s):

Logistic Regression ◽

Liver Disease ◽

Fatty Liver ◽

Thyroid Function ◽

Fatty Liver Disease ◽

Multivariate Logistic Regression Analysis ◽

Elderly Subjects ◽

Multivariate Logistic Regression ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease

Introduction and aims. The association between thyroid function and non-alcoholic fatty liver disease (NAFLD) remained controversial. A large cross-sectional study aimed to explore the relationship in euthyroid population. Material and methods. A total of 1773 euthyroid subjects who underwent health check-up during one-year period were enrolled. NAFLD was diagnosed by ultrasound and fatty liver index (FLI). Fibrosis was estimated by BARD score. Thyroid function parameters, including thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4), were recorded. Multivariate logistic regression analyses were performed to identify the independent risk factors. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Results. NAFLD was diagnosed by ultrasound in 638 (35.98%) subjects and by FLI ≥ 60 in 694 (39.14%) subjects. Regardless of ultrasound or FLI, the overall analysis demonstrated that TSH and FT3 levels were significantly higher in subjects with NAFLD than subjects without NAFLD, but FT4 level was not significantly different between them. This association remained in middle-age subjects, but not elderly subjects. In the multivariate logistic regression analysis, TSH (OR = 1.108, 95%CI = 1.056-1.398, P = 0.024) and FT3 (OR = 1.258, 95%CI = 1.123-1.409, P = 0.000) levels were independently associated with the risk of NAFLD diagnosed by ultrasound; and only FT3 level (OR = 1.252, 95%CI = 1.074 - 1.460, P = 0.004) was independently associated with the risk of NAFLD estimated by FLI ≥ 60. Additionally, FT3 level (OR = 1.178, 95%CI = 1.025 - 1.354, P = 0.021) was independently associated with the risk of fibrosis estimated by BARD score ≥ 2 in NAFLD subjects. Conclusion. Among the euthyroid population, FT3 and TSH levels were positively associated with the risk of NAFLD.

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Association of non-alcoholic fatty liver disease and polycystic ovarian syndrome

BMJ Open Gastroenterology ◽

10.1136/bmjgast-2019-000352 ◽

2020 ◽

Vol 7 (1) ◽

pp. e000352 ◽

Cited By ~ 1

Author(s):

Mohammad Maysara Asfari ◽

Muhammad Talal Sarmini ◽

Firas Baidoun ◽

Yasser Al-Khadra ◽

Yamen Ezzaizi ◽

...

Keyword(s):

Logistic Regression ◽

Liver Disease ◽

Fatty Liver ◽

Fatty Liver Disease ◽

Polycystic Ovarian Syndrome ◽

National Database ◽

Multivariate Logistic Regression ◽

Alcoholic Fatty Liver ◽

Alcoholic Fatty Liver Disease ◽

Ovarian Syndrome

BackgroundPolycystic ovarian syndrome (PCOS) is a common endocrine disorder in women. Women with PCOS have androgen excess as a defining feature. They also have increased insulin resistance and obesity, which are also risk factors for non-alcoholic fatty liver disease (NAFLD). However, published data regarding PCOS as independent risk factor for NAFLD remain controversial. Therefore, we conducted this study to evaluate the association between PCOS and NAFLD using a large national database.MethodsWe identified adult female patients (≥18 years) with PCOS using the National Inpatient Sample database between 2002 and 2014. The control group included patients who did not have a diagnosis of PCOS. Multivariate logistic regression analysis was performed to study the association of NAFLD with PCOS.ResultsOut of a total of 50 785 354 women, 77 415 (0.15%) had PCOS. These patients were younger (32.7 vs 54.8; p<0.001) and more likely to be obese (29.4% vs 8.6%; p<0.001) compared with non-PCOS patients. However, the PCOS group had less hypertension (23.2% vs 39.8%), dyslipidaemia (12% vs 17.8%) and diabetes mellitus (18.1% vs 18.3%) (p<0.001 for all). Using multivariate logistic regression, patients with PCOS had significantly higher rate of NAFLD (OR 4.30, 95% CI 4.11 to 4.50, p<0.001).ConclusionOur study showed that patients with PCOS have four times higher risk of developing NAFLD compared with women without PCOS. Further studies are needed to assess if specific PCOS treatments can affect NAFLD progression.

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