Research led by the University of Birmingham has found that women with PCOS are more than twice as likely to develop non-alcoholic fatty liver disease (NAFLD) than women without PCOS.
The retrospective longitudinal cohort study, published in PLOS Medicine, used data from The Health Improvement Network general practice database to evaluate NAFLD rates in 63,120 UK women with PCOS and 121,064 control participants registered from January 2000 to May 2016.
Participants with PCOS were found to have an increased rate of NAFLD compared with matched control participants (HR 2.38; P<.001). The incidence of NAFLD in women with PCOS was 9.2 per 10,000 person-years compared with 3.9 per 10,000 person-years in control participants. The estimated risk remained similar after adjustment for age.
Serum testosterone levels of 3-3.49 nmol/L was associated with a 2.3-fold increased risk for NAFLD (HR, 2.30; P=.017) while levels of >3.5 nmol/L increased the risk 2.4-fold (HR, 2.40; P=.009). Mirroring this finding, sex hormone-binding globulin levels of 20-29.99 nmol/L and <20 nmol/L were associated with HRs of 4.75 (P<.001) and 4.98 (P<.001), respectively.
The authors concluded that, in addition to increased BMI and dysglycaemia, androgen excess contributes to the development of NAFLD in women with PCOS. In women with PCOS-related androgen excess, systematic NAFLD screening should be considered, they advised.
