Prevalence of Metabolic Syndrome in Postmenopausal Women with Non-Alcoholic Fatty Liver Disease

Abstract

Background: Menopause is accompanied by changes in body-fat distribution, insulin sensitivity and lipid metabolism that may increase susceptibility to metabolic syndrome and hepatic steatosis. Aim: To assess metabolic syndrome parameters and their relationship with ultrasonographic hepatic steatosis in postmenopausal women. Methods: This hospital-based observational study included 50 postmenopausal women evaluated in the Postgraduate Department of Physiology and Department of Gastroenterology, Government Medical College, Jammu, over one year. Anthropometry, blood pressure, fasting glucose and lipid profile were recorded. Metabolic syndrome was defined using the NCEP ATP III criteria: at least three of the following: waist circumference ≥88 cm, triglycerides >150 mg/dL, HDL cholesterol <50 mg/dL, blood pressure ≥130/85 mmHg or antihypertensive treatment, and fasting blood glucose ≥110 mg/dL. Hepatic steatosis was graded by ultrasonography from grade 0 to grade 3. Results: Twenty-six of 50 women (52.0%) met the criteria for metabolic syndrome. Compared with women without metabolic syndrome, those with metabolic syndrome had higher weight (74.00±5.43 vs 61.96±4.48 kg; P<0.001), BMI (29.42±1.76 vs 25.09±1.13 kg/m²; P<0.001), waist circumference (97.42±3.30 vs 89.88±4.73 cm; P<0.001), hip circumference (100.85±3.35 vs 92.75±5.34 cm; P<0.001), diastolic blood pressure (84.23±7.26 vs 79.17±6.28 mmHg; P=0.012), total cholesterol (167.46±17.80 vs 149.46±22.35 mg/dL; P=0.003), triglycerides (213.19±45.77 vs 134.08±20.24 mg/dL; P<0.001) and fasting glucose (130.08±24.41 vs 108.29±17.97 mg/dL; P=0.001), while HDL cholesterol was lower (39.08±5.86 vs 52.13±3.96 mg/dL; P<0.001). Ultrasonography showed grade 0 in 41 (82.0%), grade 1 in 2 (4.0%), grade 2 in 5 (10.0%) and grade 3 in 2 (4.0%) women. All nine women with grade 1–3 steatosis belonged to the metabolic syndrome group. Conclusion: Metabolic syndrome was common in this postmenopausal sample and was characterized principally by greater adiposity, hypertriglyceridemia, low HDL cholesterol and higher fasting glucose. Ultrasonographically detectable hepatic steatosis occurred only among women with metabolic syndrome, supporting a close relationship between metabolic abnormalities and fatty liver in postmenopausal women.

Keywords: postmenopause; metabolic syndrome; hepatic steatosis; NAFLD; obesity; dyslipidemia