非酒精性脂肪性肝病与多囊卵巢综合征相关性研究

目的探讨非酒精性脂肪肝(NAFLD)与多囊卵巢综合征(PCOS)的相关性。方法选择PCOS患者47例和非PCOS患者47例,比较两组患者NAFLD、胰岛素抵抗(IR)、丙氨酸氨基转移酶(ALT)升高发生情况及一般临床参数。结果 PCOS组NAFLD、IR、ALT升高的发生率分别为42.6%、68.1%、34.0%,与对照组(分别为17.0%、10.6%、8.5%)比较显著增高,差异有统计学意义(P0.01);PCOS组伴NAFLD患者与不伴NALFD患者比较,ALT、睾酮(TESTO)显著增高,差异有统计学意义(P0.01)。体重指数(BMI)、促卵泡成熟激素(FSH),人促黄体生成激素(LH2)、睾酮(TESTO)两两相比较,差异有统计学意义(P0.05);PCOS伴NAFLD患者年龄小于不伴NAFLD的PCOS患者(P0.01);多因素Logisitc回归分析提示ALT的异常及胰岛素抵抗状态是PCOS伴发NAFLD的主要风险因素(ALTOR=1.12,P=0.01;HOMA-IROR=1.58,P=0.01)。结论 NAFLD在PCOS患者中患病率高,提示两种疾病有临床相关性,对年轻的PCOS患者有必要尽早进行肝脏疾病的相关检查。

A study of the relationship between nonalcoholic fatty liver disease and polycystic ovary syndrome

Objective To explore the relationship between nonalcoholic fatty liver disease and polycystic ovary syndrome. Methods A case control study was performed to compare 47 non-pregnant patients with polycystic ovary syndrome with 47 non-pregnant without polycystic ovary syndrome. Clinic anthropometric variables,the prevalence of nonalcoholic fatty liver disease,insulin resistance,abnormal liver function were determined. Results The occurrence of nonalcoholic fatty liver disease,insulin resistance and elevated aminotransferase was 42.6%,68.1% and 34.0%,higher than those in control group respectively （17.0%,10.6%,8.5%,P0.01）;Compared with patients without nonalcoholic fatty liver disease,patients with nonalcoholic fatty liver disease had significantly increased body mass index,HOMA-IR,follicle-stimulating hormone,luteinizing hormone（P0.05）,alanine aminotransferase and testosterone （P0.01）;Patients with polycystic ovary syndrome and nonalcoholic fatty liver disease were younger than the patients only with polycystic ovary syndrome （P0.01）;Logistic analysis showed that elevated aminotransferase and HOMA-IR had obvious relationship with polycystic ovary syndrome complicated with nonalcoholic fatty liver disease （ALT OR=1.1,P=0.01;HOMA-IR OR=1.6,P=0.01）. Conclusion Nonalcoholic fatty liver disease is common in patients with polycystic ovary syndrome,which suggests an association between those two conditions.Young women with polycystic ovary syndrome should be screened for liver disease early.