Non-Alcoholic Fatty Liver Disease in Patients with Polycystic Ovary Syndrome : A Systematic Review, Meta-Analysis, and Meta-Regression
Manzano-Nuñez, Ramiro (Universitat Autònoma de Barcelona. Facultat de Medicina)
Santana-Dominguez, Marta (Hospital Clínic i Provincial de Barcelona)
Rivera Esteban, Jesús (Universitat Autònoma de Barcelona. Facultat de Medicina)
Sabiote, Clara (Hospital Universitari Vall d'Hebron)
Sena, Elena (Hospital Universitari Vall d'Hebron)
Bañares, Juan (Hospital Universitari Vall d'Hebron)
Tacke, Frank (Charité-Universitätsmedizin Berlin)
Pericàs, Juan M. (Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas)

Data:	2023
Resum:	Background: The metabolic effects of polycystic ovary syndrome (PCOS) may increase the risk of non-alcoholic fatty liver disease (NAFLD). However, the burden of NAFLD in PCOS has not been unequivocally defined. This systematic review (SR), meta-analysis (MA) assessed NAFLD's prevalence, and risk factors in patients with PCOS. Methods: A literature search was performed in MEDLINE, Scopus, and Scielo. First, we performed a MA of proportions to estimate the prevalence of NAFLD in PCOS. Second, we performed meta-analyses of precalculated adjusted odds ratios to examine NAFLD risk factors. Finally, we performed a meta-regression to model how the estimated prevalence changed with changes in prespecified variables. Results: We identified 817 articles from the database searches. Thirty-six were included. MA of proportions found a pooled NAFLD prevalence of 43% (95% CI, 35-52%) with high heterogeneity (I 2 = 97. 2%). BMI, waist circumference, ALT values, HOMA-IR values, free androgen index levels, hyperandrogenism, and triglycerides were associated with significantly higher risk-adjusted odds of NAFLD among patients with PCOS. Meta-regression showed that rises in NAFLD prevalence were mediated through increases in metabolic syndrome prevalence and higher levels of HOMA-IR, free androgen index, and total testosterone. Conclusion: The prevalence of NAFLD (43%) among PCOS patients is high despite their average young age, with several metabolic and PCOS-specific factors influencing its occurrence. Screening programs may aid in detecting metabolic-associated fatty liver disease and prevent its consequences. Further work is required to establish the burden of liver-related outcomes once NAFLD has progressed in the PCOS population.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Non-alcoholic fatty liver disease ; Metabolic dysfunction associated fatty liver disease ; Polycystic ovary syndrome ; Prevalence ; Risk factors
Publicat a:	Journal of clinical medicine, Vol. 12 (january 2023) , ISSN 2077-0383

DOI: 10.3390/jcm12030856
PMID: 36769504

18 p, 1.3 MB

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