Djuro Macut*, Jelica Bjekić-Macut, Sarantis Livadas, Olivera Stanojlović, Dragan Hrnčić, Aleksandra Rašić-Marković, Danijela Vojnović Milutinović, Violeta Mladenović and Zoran Andrić Pages 1 - 5 ( 5 )
Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women during reproductive period. True PCOS phenotype is prone to develop metabolic consequences during life. Obese PCOS women with insulin resistance are carrying risk for development type 2 diabetes, and influencing liver function by generating liver steatosis and nonalcoholic fatty liver disease (NAFLD). Moreover, serum testosterone of over 3 nmol/L is associated with at least two-fold higher risk for the development of NAFLD in PCOS women. Numerous genes involved in the pathogenesis of hyperandrogenism, insulin resistance and inflammation are associated with development of NAFLD in PCOS women. Liver biopsy is not considered as the first line procedure for the diagnosis of liver damage in a prevalent condition as PCOS. Therefore, simple and reliable surrogate markers as serum aminotransferases levels or different surrogate indexes (i.e. fatty liver index and NAFLD-fatty liver score) could be used for the assessment of fatty liver in PCOS women. First line therapeutic approach for NAFLD in PCOS include change in lifestyle that imply dietary regiment and physical activity but without well-defined protocols. Second line therapy consider addition of drugs on the established lifestyle change. Metformin remains the drug of choice for reduction of insulin resistance and liver enzymes level. Liraglutide, glucagon-like peptide-1 receptor agonists, showed favorable effects on the reduction of liver fat content and visceral adipose tissue in overweight women with PCOS. Current review analyze the impact of metabolic risk factors, diagnostic approach and management options for NAFLD in women with PCOS.
nonalcoholic fatty liver disease, polycystic ovary syndrome, insulin resistance, hyperandrogenism, metformin, liraglutide
Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Faculty of Medicine, University of Belgrade, Belgrade, UMC Bežanijska kosa, Faculty of Medicine, University of Belgrade, Belgrade, Endocrine Unit, Metropolitan Hospital, Athens, Institute of Medical Physiology, Faculty of Medicine; University of Belgrade, Belgrade, Institute of Medical Physiology, Faculty of Medicine; University of Belgrade, Belgrade, Institute of Medical Physiology, Faculty of Medicine; University of Belgrade, Belgrade, Institute for Biological Research “Siniša Stanković”, University of Belgrade, Belgrade, Center for Endocrinology, Diabetes and Metabolic Diseases, Clinical Center Kragujevac, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, UMC Bežanijska kosa, Faculty of Medicine, University of Belgrade, Belgrade