Long and irregular menstrual cycles may increase the risk of NAFLD in premenopausal women

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March 03, 2022

3 minute read

Source/Disclosures

Disclosures:
The authors report no relevant financial information.


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Premenopausal women with long or irregular menstrual cycles have a higher risk of prevalent and incident non-alcoholic fatty liver disease compared to women with normal cycles, according to the study results.

Seungho Ryu

“Long or irregular menstrual cycles were associated with a higher prevalence and also an increased risk of developing non-alcoholic fatty liver disease in young premenopausal women, and this association was not explained by obesity,” Seungho Ryu, MD, PhD, professor at the Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine and SAIHST, Sungkyunkwan University in Seoul, South Korea, Healio told Healio. “Young premenopausal women with long or irregular menstrual cycles should be aware of the future risk of developing non-alcoholic fatty liver disease and advised to adopt healthy lifestyle behaviors such as regular physical activity and healthy eating habits for reduce the risk of developing non-alcoholic fatty liver disease and other metabolic diseases.

Long and irregular menstrual cycles increase the risk of NAFLD.

Women with a menstrual cycle longer than 30 days or an irregular cycle have an increased risk of developing NAFLD. Data are from Cho IY et al. J Clin Endocrinol Metab. 2022; doi:10.1210/clinem/dgac068.

Ryu and her colleagues analyzed data from the Kangbuk Samsung Study on the health of 135,090 premenopausal women under the age of 40 who had annual or biannual health checkups at health care centers in Seoul or Suwon, in South Korea. Participants participated in a comprehensive health examination from 2011 to 2017 and had at least one follow-up examination by December 31, 2019. Menstrual cycle length was self-reported and cycle length was classified as less than 21 days , 21 to 25 days, 26 to 30 days, 31 to 39 days and 40 days or more or too irregular to estimate. The women were diagnosed with non-alcoholic fatty liver disease (NAFLD) based on fatty liver observed on abdominal ultrasound.

At baseline, 7.1% of the cohort had prevalent NAFLD and 27.7% had an irregular menstrual cycle or a cycle length of 40 days or longer. After adjusting for covariates, women with a menstrual cycle length of 31 to 39 days (adjusted prevalence ratio [aPR] = 1.27; 95% CI, 1.19-1.36) or 40 days or more (aPR = 1.35; 95% CI, 1.28-1.42) had a higher risk of NAFLD compared to women with a menstrual cycle of 26 to 30 days.

In the subgroup of women without NAFLD at baseline, 4524 cases of NAFLD were diagnosed during a mean follow-up of 4.4 years. Compared with women with a menstrual cycle of 26-30 days, those with a cycle of 31-39 days (aHR = 1.27; 95% CI, 1.15-1.39) or those with a cycle of more 40 days or an irregular cycle (aHR = 1.49; 95% CI, 1.38-1.6) had an increased risk of being diagnosed with NAFLD. In the sensitivity analysis, having a menstrual cycle of at least 40 days or an irregular cycle was also associated with a higher risk of moderate or severe NAFLD.

In an analysis of 18,968 women with data from pelvic ultrasound and gynecological assessments, those with a menstrual cycle of 31–39 days (aPR=1.28; 95% CI, 1.11–1.46) and a cycle longer than 40 days or irregular (aPR = 1.42; 95% CI, 1.27-1.58) had an increased likelihood of NAFLD. In 14,378 women with NAFLD or suspected polycystic ovary syndrome at baseline, there was also an increased risk of NAFLD in those with a menstrual cycle of 31–39 days (aHR=1.23; 95% CI, 1 .03-1.47) or a menstrual cycle of 40 days. -more or irregular cycle (aHR = 1.32; 95% CI, 1.15-1.52).

“The association between long or irregular cycles and the risk of developing NAFLD was independent of obesity and consistently observed in women without polycystic ovary syndrome, meaning that women with long or irregular menstrual cycles should be encouraged to engage in healthy lifestyle behaviors regardless of their obesity status or PCOS,” Ryu said.

Ryu said future research should include hormonal measures that can explain associations between long and irregular menstrual cycles and NAFLD. Future research is also needed to determine whether implementing healthy lifestyle behaviors in women with long or irregular cycles can reduce the risk of NAFLD.

For more information:

Seungho Ryu, MD, PhDcan be contacted at [email protected]

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