Evaluation of hepatic fibrosis in polycstic over syndrome by using shear wave elastography

Aim: Women with polycystic ovary syndrome (PCOS) have an increased risk of developing non-alcohol related fatty liver disease (NAFLD), steatohepatitis (NASH) and hepatic fibrosis secondary to chronic inflammation. The aim of the study is to try to identify liver fibrosis that may develop in PCOS at an early stage through periostin and matrix metalloproteinase-3 (MMP-3) serum levels and 2D shear wave elastography (SWE). Material and Methods: 33 patients and 33 healthy volunteers were included in our study. Complete blood count, routine biochemical parameters, serum androgen level and free androgen index (FAI), hs-CRP, periostin and MMP-3 levels were measured. Suprapubic pelvic ultrasonography was performed for diagnostic purposes. Liver and ovarian elastocities were evaluated using shear wave elastography technique. Anthropometric measurements were recorded. Data were analyzed using the SPSS 21 package program. Results: Periostin (39,40 ± 19,79, 20,61 ± 11,32 ng/ml) and MMP-3 (36,83 ± 11,61, 26.66 ± 10,77 ng/ml) in the group with PCOS compared to the control group levels were found to be high. This situation indicates statistical significance for both determinants (p<0,001, p<0,001, respectively). In our patient group, a positive correlation was found between both Fib-4 score and periostin (r=0,433, p=0,012) and between Fib-4 score and kc elastography (r=0,374, p=0,032). There was a significant difference between the groups in favor of the PCOS group in terms of serum testosterone level (p=0,044) and FAI (p=0,037). Conclusion: Serum periostin and androgen levels were found to be high in our patient group. Also in this group, a positive correlation was found between Fib-4 score and periostin and liver elastocyte. These data suggest that in the early detection of liver fibrosis in PCOS cases, serum periostin level and 2D-SWE, in addition to Fib-4 score, can clinically help us. Key words: PCOS, liver fibrosis, periostin, MMP-3, 2D-shear wave elastography