Nonalcoholic Fatty Liver Disease in Patients with Polycystic Ovary Syndrome
2019
Authors:
Macut, ĐuroBjekić-Macut, Jelica
Livadas, Sarantis
Stanojlović, Olivera
Hrnčić, Dragan
Rašić-Marković, Aleksandra
Vojnović-Milutinović, Danijela
Mladenović, Violeta
Andrić, Zoran
Document Type:
Article (Published version)
,
© Bentham Science Publishers
Metadata
Show full item recordAbstract:
Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women during the reproductive period. True PCOS phenotype is prone to develop metabolic consequences during life. Obese PCOS women with insulin resistance are carrying a risk for developing type 2 diabetes, and influencing liver function by generating liver steatosis and nonalcoholic fatty liver disease (NAFLD). Moreover, serum testosterone of over 3 nmol/L is associated with at least two-fold higher risk for the development of NAFLD in PCOS women. Numerous genes involved in the pathogenesis of hyperandrogenism, insulin resistance and inflammation are associated with the development of NAFLD in PCOS women. Liver biopsy is not considered as the first line procedure for the diagnosis of liver damage in a prevalent condition as PCOS. Therefore, simple and reliable surrogate markers as serum aminotransferases levels or surrogate indexes (i.e. fatty liver index and NAFLD-fatty liver score) could be used for the assessment of fatty liver in PCOS women. First line therapeutic approach for NAFLD in PCOS includes a change in lifestyle that implies dietary regiment and physical activity but without well-defined protocols. Second line therapy considers addition of drugs on the established lifestyle change. Metformin remains the drug of choice for reduction of insulin resistance and liver enzymes level. Liraglutide, glucagon-like peptide-1 receptor agonists, showed favorable effects on the reduction of liver fat content and visceral adipose tissue in overweight women with PCOS. Current review analyzes the impact of metabolic risk factors, diagnostic approach and management options on NAFLD in women with PCOS.
Keywords:
Nonalcoholic fatty liver disease; Polycystic ovary syndrome; Insulin resistance; Hyperandrogenism; Metformin; LiraglutideSource:
Current Pharmaceutical Design, 2019, 24, 38, 4593-4597Funding / projects:
- Role of steroid hormones in neuroendocrine adaptation to stress and pathophysiology of metabolic syndrome - molecular mechanisms and clinical implications (RS-MESTD-Integrated and Interdisciplinary Research (IIR or III)-41009)
- The development of animal models of epilepsy and testing convulsive and anticonvulsive substances (RS-MESTD-Basic Research (BR or ON)-175032)
DOI: 10.2174/1381612825666190117100751
ISSN: 1381-6128