Prevalence and significance of nonalcoholic fatty liver disease in adolescent girls with polycystic ovary syndrome

Adolescents with Polycystic Ovary Syndrome (PCOS) are at risk of nonalcoholic fatty liver (NAFLD) and the metabolic syndrome. Methods Cross-sectional study. Adolescents in the Western Australian Pregnancy Cohort (Raine Cohort) Study participated in the menstruation in teenagers study (n = 244 females) and NAFLD study (n = 578 females, 592 males). Assessments included questionnaires, anthropometric, cardiovascular, ultrasound and fasting blood tests. 201 girls had both ovarian and liver ultrasounds. NAFLD was diagnosed with liver ultrasound. Results 16% of girls in the menstruation study were diagnosed with PCOS and 19% with NAFLD. NAFLD was more common in girls with PCOS than girls without PCOS (42.3% vs. 14.2%, p = 0.001) and was more common in obese than non-obese girls (64.7% vs. 0.0%, p = 0.002). Girls with PCOS plus NAFLD had greater adiposity, serum leptin and triglycerides but lower serum adiponectin than girls with PCOS without NAFLD (p 0.05 for all ). However, boys had higher ALT and AST levels and systolic blood pressure. Free testosterone concentration (FT) was higher in girls diagnosed with NAFLD than those without NAFLD (25.9 vs. 18.9 pmol/L, p = 0.02) but FT was not predictive of NAFLD after controlling for obesity. Suprailiac skinfold thickness (odds ratio 1.16, 95% CI 1.08–1.24, p < 0.001) and presence of PCOS (odds ratio 3.87, 95% CI 1.09–13.76, p = 0.04) were independent predictors of NAFLD in the menstruation study. Conclusions NAFLD is common in adolescent females with PCOS and shares metabolic similarities with male NAFLD. Obesity and PCOS have a dominant effect over testosterone levels in predicting female NAFLD.