A Hospital Based Study Correlating the Prevalence of Fatty Liver Disease in Polycystic Ovary Syndrome using Ultra Sound as Screening Modality
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 9
Abstract
Background: Women with PCOS had a higher prevalence of fatty infiltration of liver compared to women with out PCOS. In a Hospital set up ultrasonography is the most widely used screening modality for detection of fatty infiltration of liver and for PCOS, due to its low cost, non invasiveness, easy availability, mobility and reasonable level of sensitivity. Aim and Objectives: The main aim of the present study was to identify the prevalence of fatty liver as seen on ultrasonography in patients with PCOS, corroborating with laboratory and physical parameters to determine the efficacy of Ultra sound as a screening modality, as fatty liver is precursor for chronic disease like cirrhosis and hepatocellular carcinoma in some patients and PCOS is associated with increased risk of type-2-diabetes and cardiovascular diseases. Materials and Methods: It is a Prospective study using existing records, conducted at the Department of RadioDiagnosis and imaging of the GIMSR (GITAM Institute of Medical Sciences and Research), Visakhapatnam. It is a tertiary level hospital and the study was performed on total 100 numbers of samples. The patients referred to the Radiology department with complaints of amenorrhea or oligomenorrhea, belonging to the adolescent, young and adult population for PCOS diagnosis. The abdomino pelvic scan was performed on PHILIPS HD15 Ultrasound machine, using a 3 MHz curvilinear probe and transvaginal probe in married obese females, where transabdominal visualization was suboptimal, after verbal consent from the patient. No patients had a history of alcohol consumption.The presence of fatty liver in each patient was evaluated by an expert radiologist using abdominal ultrasonography (USG). The degree of fatty liver on abdominal USG was stratified as mild, moderate, or severe. The diagnosis was also based on the measurement of SGOT, SGPT levels, Lipid profile and liver enzyme aminotransferase levels. Statistical analysis: Mean, median, and standard deviations were calculated for continuous variables. Pearson's Chi-square test was used to assess differences in the groups for categorical data. The P < 0.05 was considered statistically significant. Results: The women with PCOS had significantly higher visceral fat indicated by higher waist-hip ratio, higer alanine aminotransferase (ALT) or serum glutamic pyruvic transaminase (SGPT), aspartate aminotransferase (AST) or serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP) levels and higher lipid profile values. Table-1 showed the clinical and biochemical characteristics of PCOS patients with or without fattyliver. It was found that BMI and waist-hip ratio was significantly (P<0.001) higher in PCOS patients with hepatic liver than patients without fatty liver. The lipid profile values of total cholesterol, triglycerides, VLDL, LDL were also high where as HDL was lower comparitively than patients without fatty liver. The serum enzymatic levels of SGOT, SGPT and ALP were also observed to be in higher concentrations in patients with fattyliver than patients without hepato steatosis. Conclusion: The non invasive and widely available screening methods can be used in large patient populations with NAFLD and PCOS for early detection and intervention to prevent the progression and reduce or prevent the morbidity and mortality.
Authors and Affiliations
Sonica Sharma, Bhamidipaty Kanaka Durgaprasad, Pilli Hemaprakash Kumari, Payala Vijayalakshmi
Keywords
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