Association between Non Alcoholic Fatty Liver Disease and Polycystic Ovarian Syndrome: A Systematic Review

Nonalcoholic fatty liver disease (NAFLD), has emerged as one of the most common causes of chronic liver disease and is increasingly being attributed to cirrhosis in a large number of patients. NAFLD is characterized by accumulation of fat in hepatocytes without a significant history of alcohol consumption. Since the prevalence of NAFLD is markedly increased in obesity, type 2 diabetes mellitus and dyslipidemia, the role of insulin resistance in the pathogenesis of this disease has been studied and a strong association has been found between insulin resistance and NAFLD. It is now established that NAFLD is the hepatic component of the metabolic syndrome. On the other hand, polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in premenopausal women. Insulin resistance which is the hallmark of metabolic syndrome, has also been documented in about 50% to 80% of women with PCOS. Over the past few years evidence has accumulated showing an association between nonalcoholic fatty liver disease and polycystic ovary syndrome. The pathophysiologic link and the clinical significance of this relationship are still not very well understood, however, there is sufficient data to support the same. We present here a systematic review of studies which have evaluated this association and have underlined the clinical implications of this co-existence