Risk Factors for Metabolic Dysfunction-Associated Steatotic Liver Disease in Patients With Polycystic Ovary Syndrome in East Asia: A Review and Meta-Analysis.

Renyuan Li, Zhao Wu, Ying Zhang, Guining Liang

Journal: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists 2025;31(5):668-676

PMID: 39947624

Full Text on Elsevier Science View on PubMed

Abstract

OBJECTIVES

The incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing in women with polycystic ovary syndrome (PCOS). Epidemiologic literature regarding the risk factors for MASLD in PCOS women in East Asia is inconsistent. Studies of PCOS and MASLD in East Asia are restricted by limited data and various biases. Therefore, this meta-analysis was conducted.

METHODS

This meta-analysis followed the MOOSE statement. Relevant studies published before July 13, 2023 were retrieved from the PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, Wan Fang, KISS, and Japan medical online databases. The related data were extracted, and the weighted mean difference, odds ratios and 95% confidence intervals were calculated.

RESULTS

Twenty-four studies were included. Through univariate analysis, age, body mass index, waist-to-hip ratio (WHR), blood pressure, alanine transaminase, aspartate transaminase, fasting blood glucose, fasting insulin, homeostatic model assessment for insulin resistance (HOMA-IR), 2-hour postprandial blood glucose, 2 hour insulin, HBA1C, low-density lipoprotein cholesterol, triglyceride, total cholesterol, and testosterone were notably higher in PCOS women with MASLD, with high-density lipoprotein cholesterol markedly lower in PCOS women with MASLD. According to the pooled multivariate analysis, the WHR (P < .001), testosterone (P = .034), and HOMA-IR (P = .02) were substantially greater in PCOS women with MASLD.

CONCLUSION

MASLD is associated with obesity, IR, and hyperandrogenemia among PCOS women in East Asia. The abnormality of WHR, HOMA-IR, and testosterone suggested early screening of MASLD in this population.

Address: Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, China; Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China.; Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, China; Department of Clinical Medicine, Nan Shan School of Guangzhou Medical University, Guangzhou, China.; Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, China; Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China; Department of Clinical Medicine, Nan Shan School of Guangzhou Medical University, Guangzhou, China.; Department of Endocrinology and Metabolism, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, China; Department of Clinical Medicine, The Third Clinical School of Guangzhou Medical University, Guangzhou, China; Department of Clinical Medicine, Nan Shan School of Guangzhou Medical University, Guangzhou, China. Electronic address: [email protected].

DOI: 10.1016/j.eprac.2025.01.011

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MeSH Terms: Humans, Polycystic Ovary Syndrome, Female, Risk Factors, Asia, Eastern, Fatty Liver, Insulin Resistance