Endocrine Abstracts (2008) 16 OC5.7

Hepatic steatosis is not a feature of young lean women with polycystic ovarian syndrome

Athina Markou1, Ioannis Androulakis1, Christos Mourmouris2, Aggeliki Tsikkini2, Christina Samara2, Krystallenia Alexandraki3, E Papadavid4, V Syriou3, Katerina Naka5, Georgios Piaditis1 & Gregory Kaltsas3

1Department of Endocrinology and Diabetes Center, General Hospital of Athens ‘G. Gennimatas’, Athens, Greece; 2Department of Radiology, General Hospital of Athens ‘G. Gennimatas’, Athens, Greece; 3Division of Endocrinology, Department of Pathophysiology, Laikon University Hospital, Athens, Greece; 4Department of Dermatology, Attikon University Hospital, Athens, Greece; 5Michaelidion Cardiac Center, University of Ioannina, Ioannina, Greece.

Background: Non-alcoholic fatty liver disease (NAFLD) is a very common liver disorder associated with insulin resistance and the metabolic syndrome. Insulin resistance is also a prominent feature even in lean women with the polycystic ovarian syndrome (PCOS). The objective of this study was to identify the presence of NAFLD in young lean women with PCOS.

Methods: Fifteen women with PCOS and 10 controls participated in the study.

Mean age was 25±4.65 and 24.5±5.94 years and mean body mass index was 21.7±2.5 and 23.5±3 kg/m2 for the PCOS and the control group respectively. All participants had baseline biochemical, metabolic and hormonal profile and underwent a 75 g oral glucose tolerance test with measurements of glucose and insulin every 30 min for 2 h. The following indices of insulin resistance were calculated: GIR=fasting glucose/fasting insulin, AUC (area under the curve) GIR=AUC gluc/AUC insulin, MATSUDA=10 000/square root (fasting glucose×fasting insulin)×(mean glucose×mean insulin). Only women with PCOS underwent imaging studies with ultrasound and computed tomography of the liver. Fatty infiltration of the liver was considered as positive when the CT attenuation of the liver was at least 10 Housefield Units below the CT attenuation of the spleen.

Results: Women with PCOS had higher total testosterone (0.62±0.42 vs 0.36±0.08 ng/ml, P=0.03), free androgen index (7.4±6.4 vs 2.6±0.9, P<0.05) and indices of insulin resistance (GIR P<0.05, AUC INS P<0.05, AUC GIR P<0.001, MATSUDA P<0.05) compared to controls. Although there was no evidence of NAFLD in imaging studies, a significant negative correlation between mean hepatic attenuation and waist to hip ratio ratio was found (r=−0.55, P=0.034).

Conclusions: Young lean women with PCOS do not have NAFLD besides insulin resistance. Studies with more prolonged follow-up are required to determine the evolution of hepatic changes in such patients.