Polycystic ovary syndrome (PCOS) puts adolescent patients at risk for non-alcoholic fatty liver disease, according to retrospective study data presented at the annual meeting of the Canadian Pediatric Endocrine Group. PCOS is an independent risk factor for developing NAFLD independent of BMI or the presence of insulin resistance.

Investigators found that obese and nonobese adolescents with PCOS are at risk for developing non-alcoholic fatty liver disease (NAFLD), a link that has not been explored in the pediatric population, said Mrouge Sobaihi, a Pediatric Endocrinology fellow in the Division of Endocrinology at Montreal Children’s Hospital, McGill University.

In this study, the diagnosis of PCOS was based on the Rotterdam consensus. A total of 140 patients (mean age, 15.86 years) with PCOS were identified, and 79 had their liver enzymes measured. At an ALT ≥22 U/L, the prevalence was estimated to be 72.2%. Of these, 23 patients were obese and 34 were not. Twenty patients had increased homeostatic model assessment-insulin resistance (HOMA-IR). Eighteen patients were neither obese nor were insulin resistant. At an ALT ≥37 U/L, the prevalence of NAFLD was 26.7%, and at an ALT ≥45 U/L, the prevalence fell to 10.1%.

“Our main finding is that nonobese patients also had elevated liver enzymes,” Sobaihi said. “Being lean does not remove the risk of NAFLD. We don’t know if this finding is due to a small sample size, but this study suggests we may need to screen everyone with PCOS for liver function and change our follow-up.”Given NAFLD can progress to hepatitis or cirrhosis, it is imperative to screen for it early on, Sobaihi said.