Hello, greetings.
I was wondering about possible outcomes of estrogen hormones supplementation in light of fatty liver disease in women with PCOS.
As PCOS and nonalcoholic fatty liver disease share some possible common pathophisiological tracts, i.e. insulin resistance, the prevalence of fatty liver disease in this group of patients is propably underestimated.
I was wondering about possible data on influence of estrogens supplementation (which lasts for many years in this group of patients) on course of NAFLD or even it's progression/regression?
I found a little data on this problem (see link below), or maybe I am not searching for it sufficiently well. This article concludes that estrogens may have possible hepato-protective action.
On the other hand, I've had always in my mind, that chronic liver disease remains a contrindication for estrogen-based contraception.
Maybe you have some thoughts on this topic.
Regards!
http://www.ncbi.nlm.nih.gov/pubmed/21057159
Hello,
Below are three papers. One is on the presentation of NAFLD and PCOS. The second (one that will answer your question about hepatoprotective effects of estrogen in NAFLD/PCOS) is more helpful to your specific question. It states that there are hepatoprotective benefits to estrogen supplementation in patients with PCOS and NAFLD.
Finally, the third is a paper on the benefits of estrogen in patients with chronic liver disease and hep. B infection.
Let me know if these fail to fully answer the question to your satisfaction. I am happy to keep looking for more materials.
Dear Joseph,
thank you for your post. I've already knew two first papers, however they are both very good review materials. The third paper is really interesting, this is some novelty for me. I was wondering if there was any prospective comparative study on estrogen supplementation and its influence on clinical course of fatty liver diseases.
"These results suggest that NAFLD is more prevalent in postmenopausal and PCOS women than premenopausal women and estrogens may have a protective effect"
Gutierrez-Grobe Y, Ponciano-Rodríguez G, Ramos MH, Uribe M, Méndez-Sánchez N. Prevalence of non alcoholic fatty liver disease in premenopausal, posmenopausal and polycystic ovary syndrome women. The role of estrogens. Ann Hepatol 2010; 9: 402-409
I have not found any study of this kind, I'll keep on searching.
On the other hand, the usual endocrinological therapy of PCOS consists of oral contarceptive drugs, which contain estrogens and progestogens as well. The role of progestogens and progesteron in fatty liver disease is not clear, however, I have found some data that it promotes adipocytes differentiation:
Progesterone stimulates adipocyte determination and differentiation 1/sterol regulatory element-binding protein 1c gene expression. potential mechanism for the lipogenic effect of progesterone in adipose tissue.
Lacasa D, Le Liepvre X, Ferre P, Dugail I
J Biol Chem. 2001 Apr 13; 276(15):11512-6.
It suggests lipogenic effect in adipose tissue, hovewer I have not found any study on progesterone impact on fatty liver diseases. It seems to be of interest because those patients are candidates for OCP therapy containing estrogenes+progestagenes for many years.
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