Association Between Polycystic Ovary Syndrome and Metabolic Dysfunction-Associated Steatotic Liver Disease Fibrosis Severity
Abstract
Introduction: Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder associated with increased risk of metabolic dysfunction-associated steatotic liver disease (MASLD). However, there is limited data comparing female patients with both PCOS and MASLD to those with MASLD alone. This study aims to evaluate differences in metabolic profiles and liver disease severity between these cohorts.
Methods: In this single-center retrospective study, adult patients diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD) were stratified into 3 cohorts: (1) females with both polycystic ovary syndrome (PCOS) and MASLD, (2) females with MASLD without PCOS, and (3) males with MASLD. The primary outcome was the stage of liver fibrosis at the time of MASLD diagnosis, evaluated using noninvasive fibrosis assessment tools including the NAFLD Fibrosis Score, FIB-4 Index, transient elastography, magnetic resonance elastography, and, when available, liver biopsy histology. Statistical analyses included analysis of variance (ANOVA), Pearson χ 2 test, Kruskal-Wallis test, multivariable logistic regression, and propensity score matching, followed by Wilcoxon rank-sum testing for group comparisons.
Results: A total of 885 patients were included in the analysis: 286 females with both PCOS and MASLD, 521 females with MASLD alone, and 78 age-matched males with MASLD. Females with PCOS were diagnosed with MASLD at a significantly younger age (median 32.5 y)…
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