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)

Fecha:	2023
Resumen:	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.
Derechos:	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.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Non-alcoholic fatty liver disease ; Metabolic dysfunction associated fatty liver disease ; Polycystic ovary syndrome ; Prevalence ; Risk factors
Publicado en:	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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