Role of Non-Alcoholic Fatty Liver Disease in Cardiovascular Morbidity in Polycystic Ovarian Syndrome.

Unlabelled: Polycystic Ovarian Syndrome remains as the most common endocrine disorder among females and are at increased risk of developing early onset atherosclerosis.1Studies have also demonstrated increased Carotid Intima- Media Thickness (CIMT), which is a predictor of coronary and cerebrovascular events among relatively younger women. Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease which is associated with significant morbidity and mortality and occur in higher prevalence in Polycystic ovarian syndrome patients. This study aims to estimate cardiovascular morbidity in PCOS patients with or without Non Alcoholic Fatty Liver Disease.

Material: 22 Polycystic Ovarian Syndrome patients already diagnosed by Rotterdam's criteria were included in this study.Abdominal Ultrasonography screening was used to identify patients with Non-Alcoholic Fatty Liver Disease and patients without Non Alcoholic Fatty Liver Disease. Demographic and anthropometric data was noted in both groups. Cardiovascular morbidity was assessed for all the patients using fasting blood sugar, lipid profile, SGOT, SGPT, 12 lead ECG, 2D-ECHO and CIMT. Data was entered in Microsoft Excel. Master chart was prepared and analysis was done based on compiled information.

Observation: Total 22 patients were included in the study. Non-alcoholic Fatty Liver Disease were found in 10 patients with a mean age of 36.6±7.58 (45%) and patients without Non-alcoholic Fatty Liver Disease were found in 12 patients with a mean age of 24.5±5.7 (54.5%). Fisher's Exact Test revealed significant association between the CV morbidity and the Non-alcoholic Fatty Liver Disease status of patients of Polycystic ovarian syndrome. "p" value was found to be 0.01 that showed presence of Non-alcoholic Liver Disease increases risk of Cardiovascular morbidity. Corelation of e/a ratio and LDL/HDL ratio was significant between Non-alcoholic Fatty Liver Disease and without Non-alcoholic Fatty Liver Disease. As fall in e/a ratio was found to have increased LDL/HDL ratio in group with Non-Alcoholic Fatty Liver Disease with R2=0.59. There was no significant association between e/a ratio and TG/HDL ratio between NAFLD and non NAFLD. There was no significant association between Body mass index and carotid intima media thicknesss between NAFLD and Non NAFLD.

Conclusion: There is a significant association of cardiovascular morbidity in Polycystic ovarian syndrome with Non-alcoholic Fatty Liver Disease.