Increased androgen bioavailability is associated with non-alcoholic fatty liver disease in women with polycystic ovary syndrome

The study from 2009 with 57 premenopausal women with polycystic ovary syndrome (PCOS) and 60 control women found that NAFLD is more common in women with PCOS, with a prevalence of 36.8% compared to 20.0% in controls. PCOS patients also had higher levels of androgens and liver enzymes, and lower levels of sex hormone-binding globulin (SHBG) and HDL cholesterol. The study concluded that increased androgen bioavailability, as measured by the Free Androgen Index (FAI), is associated with hepatic steatosis, independent of obesity and abdominal adiposity. The authors suggest that hyperandrogenism may contribute to the higher prevalence of NAFLD in PCOS patients and recommend liver evaluation for PCOS patients, particularly those with metabolic syndrome. The study's limitations include a small sample size and a homogenous group in terms of race and ethnicity.