Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2020; 26(44): 7046-7060
Published online Nov 28, 2020. doi: 10.3748/wjg.v26.i44.7046
Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome
Mohamed Shengir, Srinivasan Krishnamurthy, Peter Ghali, Marc Deschenes, Philip Wong, Tianyan Chen, Giada Sebastiani
Mohamed Shengir, Department of Experimental Medicine, McGill University, Montreal H4A3J1, Canada
Srinivasan Krishnamurthy, Department of Obstetrics and Gynecology, McGill University Health Centre, Montreal H4A3J1, Canada
Peter Ghali, Marc Deschenes, Philip Wong, Tianyan Chen, Giada Sebastiani, Department of Medicine, McGill University Health Centre, Montreal H4A3J1, Canada
Author contributions: Shengir M contributed to conception, study design, data, interpretation of the data; Krishnamurthy S and Chen T contributed to study design, data, interpretation of the data; Ghali P, Deschenes M and Wong P contributed to data and interpretation of data; Sebastiani G contributed to conception, study design, data and interpretation of the data, statistical analysis and first draft of the manuscript; all approved the final manuscript.
Supported by Libyan Ministry of Higher Education and Scientific Research sponsored through Canadian Bureau for International Education, No. 2979.
Institutional review board statement: The study was approved by the Research Ethics Board of the Research Institute of the MUHC (study code 2019-4584).
Informed consent statement: All study participants provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Ghali P has acted as consultant for Merck and Gilead. Deschenes M has served as an advisory board member for Merck, Janssen, Gilead; Wong P has acted as consultant for BMS, Gilead, Merck, Novartis; Sebastiani G has acted as speaker for Merck, Gilead, Abbvie, Novonordisk, Novartis, Pfizer, served as an advisory board member for Merck, Intercept, Novartis, Gilead, Allergan and has received research funding from Merck and Theratec Inc. Shengir M, Krishnamurthy S and Chen T have no conflicts of interest to declare.
Data sharing statement: According to stipulations of the patient consent form signed by all study participants, ethical restrictions imposed by our Institutional Ethics review boards (Institutional Ethics Review Board Biomedical B Research Ethics Board of the McGill University Health Centre), and legal restrictions imposed by Canadian law regarding clinical trials, anonymized data are available upon reasonable request. Please send data access requests to Sheldon Levy, Biomedical B (BMB) Research Ethics Board (REB) Coordinator Centre for Applied Ethics, 5100, boul. de Maisonneuve Ouest, 5th floor, Office 576, Montréal, Québec, H4A 3T2, Canada.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giada Sebastiani, MD, Associate Professor, Department of Medicine, McGill University Health Centre, 1001 Blvd. Decarie, Montreal H4A3J1, Canada. giada.sebastiani@mcgill.ca
Received: September 20, 2020
Peer-review started: September 20, 2020
First decision: October 17, 2020
Revised: October 30, 2020
Accepted: November 13, 2020
Article in press: November 13, 2020
Published online: November 28, 2020
Research background

Nonalcoholic fatty liver disease (NAFLD) is the most frequent liver disease worldwide. It is essential to identify higher risk groups, where screening strategies could be targeted. Women with polycystic ovary syndrome (PCOS) may be at higher risk for NAFLD.

Research motivation

To date, no study has employed transient elastography (TE) with associated controlled attenuation parameter (CAP) to screen women with PCOS for NAFLD. 

Research objectives

This work aims to determine prevalence and associated predictors of NAFLD and prevalence of significant liver fibrosis in South Asian women with PCOS.

Research methods

A routine screening program through TE with CAP was conducted at a single centre. NAFLD was defined as CAP ≥ 288 decibels per meter. Significant liver fibrosis was defined as TE measurement ≥ 8.0 kilopascals. Predictors of NAFLD were determined by logistic regression analysis.

Research results

Prevalence of NAFLD and significant liver fibrosis was 39.6% and 6.9%, respectively. Independent predictors of NAFLD were higher body mass index, hyperandrogenism and elevated alanine aminotransferase.

Research conclusions

NAFLD diagnosed by TE with CAP is a frequent comorbidity in South Asian women with PCOS, who can also develop liver fibrosis despite their young age.

Research perspectives

To reduce the burden and complications of NAFLD, non-invasive screening strategies should be considered in South Asian women with PCOS.