Session: SUN 554-573-Ovarian & Uterine Function I
Poster Board SUN-560
Methods: Thirty Tanner stage V obese adolescent girls diagnosed with PCOS were studied [age: 16.1±0.3yrs; BMI%: 97.6±0.3; free testosterone: 8.7±0.8pg/ml, (mean±SEM)]. Liver fat was evaluated with computed tomography (CT) and fatty liver index (FLI) expressed as the ratio of liver to spleen Hounsfield attenuation units (HU) (liver HU/spleen HU < 1 indicative of fatty liver). In vivo insulin-stimulated glucose disposal was measured by a 3-hr hyperinsulinemic (80mu/m2/min)-euglycemic clamp, whole-body lipolysis and fat oxidation by [2H5]glycerol and indirect calorimetry respectively, body composition by dual energy x-ray absorptiometry, abdominal adiposity by CT scan at L4-5 intervertebral space. Fasting blood was obtained for lipoprotein particle size and concentration and liver enzymes (ALT, AST).
Results: Fatty liver was present in 2 individuals (6.7%). ALT and AST were not different between those with fatty liver vs. without (ALT: 28.0±5.0 vs. 27.4±1.7, p=0.93; AST: 23.0±1.0 vs. 22.9±0.8, p=0.98). FLI was associated with age (r=-0.53, p=0.003), total (r=-0.43, p=0.03) and subcutaneous (r=-0.41, p=0.04) abdominal adipose tissue, insulin-stimulated glucose disposal (r=0.36, p=0.05), small, medium small, and very small LDL concentrations (r>=-0.43, p=0.03). There was a trend for an association between FLI and lipolysis (r=-0.32, p=0.09), and no relationship to fat oxidation. In a multiple regression analysis, age, total testosterone, race and insulin-stimulated glucose disposal explained 43% of the variance (R2=0.43, p=0.006) in FLI, with age (R2=0.28, p=0.002) and total testosterone (R2=0.11, p=0.03) being significant independent contributors.
Conclusion: These observations suggest that in obese adolescent girls with PCOS, liver fat is associated with increasing age, increasing abdominal adiposity, worsening insulin sensitivity and dyslipoproteinemia. Targeting these abnormalities early in the course of PCOS may halt future NAFLD in adulthood.
Disclosure: SAA: Advisory Group Member, Novo Nordisk, Advisory Group Member, Sanofi, Advisory Group Member, Bristol-Myers Squibb, Consultant, Gilead Science,Inc., , Boehringer Ingelheim. Nothing to Disclose: SFM, SFL, HMT
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