Abstract

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of liver disease in developed countries. This condition includes benign non-alcoholic fatty liver disease and non-alcoholic steatohepatitis with possible fibrosis leading to cirrhosis and hepatocellular carcinoma. Association of NAFLD and polycystic ovary syndrome (PCOS) has been widely discussed. Women with PCOS are prone to develop NAFLD more often. PCOS is one of the most common endocrine disorders among reproductive-age women, characterized by an excess of androgens, anovulation, and polycystic ovary on ultrasound. Obesity, dyslipidemia and insulin resistance (IR) are frequently observed in women with PCOS, being also important factors predisposing to the development of NAFLD. IR may stimulate theca cells to excessive production of androgens, inhibits the production of sex hormone-binding globulin in the liver, which contributes to the increase of the bioactive form of testosterone. Hyperandrogenemia also plays an important role in NAFLD pathogenesis and progression. Androgen excess promotes visceral fat accumulation, development of dyslipidemia, IR, and contributes to low-grade inflammation. The pathophysiological associations between PCOS and NAFLD are not fully understood although it seems reasonable to screen PCOS women for the presence of NAFLD.

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