Nonalcoholic Fatty Liver Disease in Women with Polycystic Ovarian Syndrome: A Narrative Review

Polycystic ovarian syndrome (PCOS) has been estimated to affect 10-15 percent of women in the U.S. Emerging research has found higher rates of nonalcoholic fatty liver disease (NAFLD) among PCOS individuals. While the mechanism continues to be poorly understood the aim of this review is to convey the most recent knowledge regarding the pathogenesis, diagnosis, and treatments for NAFLD in PCOS patients. Elements of insulin resistance, hyperandrogenism, obesity, and chronic inflammation are culprits in the pathogenesis of NAFLD in these patients therefore early liver screening and diagnosis is essential. Although liver biopsy remains the gold standard, advances in imaging modalities show accurate diagnosis and some can even assess the risk of progression to cirrhotic states. Apart from lifestyle modifications resulting in weight loss, other treatments with bariatric surgery, thiazolidinediones, angiotensin-converting enzyme inhibitors (ACE-I)/angiotensin-receptor blockers (ARBs), and vitamin E show promising results.