Endocrine Abstracts

Introduction

The prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) varies according to age, gender and nationality. In the general population, the incidence is about 15–25%. Liver disease increases with age and its prevalence is higher in menopausal women suggesting that steroid sex hormone metabolism may play a role in the pathogenesis of NAFLD.

Aim

The purpose of this systematic review was to investigate the prevalence and association of NAFLD in menopause.

Method

An extensive literature search was conducted until January 2021 through electronic databases (PubMed, Scopus, Cinahl) with the Medical Subject Headings and entry terms of “menopause”, “non-alcoholic fatty liver disease” and “prevalence”. The search yielded 56 results, 5 of which fulfilled the inclusion requirements according to the PRISMA checklist.

Results

One Brazilian study investigated the prevalence and risk factors of NAFLD in 188 postmenopausal women. A higher prevalence of NAFLD was detected among postmenopausal women. The presence of metabolic syndrome, abdominal obesity, and insulin resistance appeared to be risk indicators for developing NAFLD. Α Chinese study demonstrated that obese and postmenopausal women had a high prevalence of NAFLD with severe metabolic disorders. Similarly, a study of 197 premenopausal, postmenopausal women, and women with PCOS found that NAFLD had a higher prevalence among postmenopausal women and women with PCOS than in premenopausal ones. Another study that examined the relationship between menopause and the prevalence of NAFLD in 1.559 middle-aged women stated an increased prevalence of NAFLD in the late stages of menopause as well as in the postmenopausal stages, regardless of the potential confounders. A Korean study in ​​1793 postmenopausal women, evaluated the relationship between vascular motor symptoms and NAFLD in this population. Moderate to severe vascular motor symptoms were found to be significantly associated with a higher prevalence of NAFLD in otherwise healthy postmenopausal women.

Conclusion

In this systematic review, the prevalence of NAFLD in menopause was highlighted. However, these results were based upon data from a limited number of studies and it is unclear if this association is valid. Large randomized controlled trials and meta-analyses could provide more definitive evidence regarding the association of NAFLD and menopause. Due to the lack of an adequate number of studies and the heterogeneity of the study population, a meta-analysis was not possible to be performed at this time.