Evaluation of the predictive value of body mass index (BMI), waist circumference, and visceral fat to differentiate non-alcoholic fatty liver (NAFLD) in women with polycystic ovary syndrome

Abstract

Background: Our objective was to determine the overall prevalence of nonalcoholic fatty liver disease (NAFLD) in women with polycystic ovarian syndrome (PCOS) in our sample population. The second aim was to evaluate the predictive value of body mass index (BMI), waist circumference (WC), and visceral fat for the onset of NAFLD in these patients. Materials and Methods: This cross-sectional study was performed on 71 women with PCOS who were referred to Arash Women's Hospital in Tehran. Demographic and clinical information and anthropometric and biomedical indices were collected by a trained nurse. Liver ultrasonography was performed for all participants by a radiologist. Results: NAFLD was identified in 53.5% (n = 38) of subjects and the frequency of mild, moderate, and severe grades were 65.8%, 31.6%, and 2.6%, respectively. BMI and visceral fat of patients with NAFLD were significantly higher than non-NAFLD (P < 0.001). Receiving operating characteristic (ROC) curve analysis revealed that BMI was the best indicator of predicting NAFLD (cutoff = 25.5 kg/m2, sensitivity 75%, and specificity 75%), whereas visceral fat (cutoff = 5.5%, sensitivity 79%, and specificity 67%) and WC (cutoff = 89.5 cm, sensitivity 73%, and specificity 64%) were inferior for predicting NAFLD in PCOS patients. Conclusion: The prevalence of NAFLD in the study population is high. Our findings supported the use of BMI as a simple and practical predictive factor for the NAFLD onset, with a cutoff level of 25.5. The use of this cutoff level will enable physicians to identify PCOS patients at risk for NAFLD.

Keywords

• body mass index
• nonalcoholic fatty liver disease
• polycystic ovarian syndrome
• predictive value of test
• visceral fat
• waist circumference