TY - JOUR
T1 - Oral contraceptive pill use is associated with reduced odds of nonalcoholic fatty liver disease in menstruating women
T2 - Results from NHANES III
AU - Liu, Su Hsun
AU - Lazo, Mariana
AU - Koteish, Ayman
AU - Kao, W. H.Linda
AU - Shih, Ming Hsiung
AU - Bonekamp, Susanne
AU - Hernaez, Ruben
AU - Clark, Jeanne M.
PY - 2013/10
Y1 - 2013/10
N2 - Background: Higher prevalence of nonalcoholic fatty liver disease (NAFLD) in men and postmenopausal women than in premenopausal women has suggested a potential role of sex hormones in the pathogenesis of the disease. We sought to evaluate the association between oral contraceptive pills (OCP) and NAFLD and to determine whether adiposity mediates any effect. Methods: We included 4338 women aged 20-60 years who were enrolled in the Third National Health and Nutrition Examination Survey from 1988 to 1994 in a population-based cross-sectional study. We defined NA-FLD as moderate-severe steatosis on ultrasonography in women without excessive alcohol use or other identifiable causes. OCP use was based on self-report and was categorized as never, former or current use. Results: The overall weighted prevalence of NAFLD was 11.6 % but lower in current (6.7 %) than in former (12.0 %) or never users (15.6 %, P - 0.016). In the multivariable model, current OCP users experienced a 50 % lower odds of NAFLD than never users (adjusted odds ratio 0.50; 95 % confidence interval 0.26, 0.98) after adjusting for age, race/ethnicity, smoking status, history of diabetes or hypertension and education. Further adjustment for body mass index or waist circumference significantly attenuated the OCP-NAFLD relationship. Conclusions: In this large US-representative population, OCP use was associated with reduced odds of NAFLD. However, this association could be mediated or confounded by adiposity. Prospective studies are needed to further clarify the causal role of sex hormone.
AB - Background: Higher prevalence of nonalcoholic fatty liver disease (NAFLD) in men and postmenopausal women than in premenopausal women has suggested a potential role of sex hormones in the pathogenesis of the disease. We sought to evaluate the association between oral contraceptive pills (OCP) and NAFLD and to determine whether adiposity mediates any effect. Methods: We included 4338 women aged 20-60 years who were enrolled in the Third National Health and Nutrition Examination Survey from 1988 to 1994 in a population-based cross-sectional study. We defined NA-FLD as moderate-severe steatosis on ultrasonography in women without excessive alcohol use or other identifiable causes. OCP use was based on self-report and was categorized as never, former or current use. Results: The overall weighted prevalence of NAFLD was 11.6 % but lower in current (6.7 %) than in former (12.0 %) or never users (15.6 %, P - 0.016). In the multivariable model, current OCP users experienced a 50 % lower odds of NAFLD than never users (adjusted odds ratio 0.50; 95 % confidence interval 0.26, 0.98) after adjusting for age, race/ethnicity, smoking status, history of diabetes or hypertension and education. Further adjustment for body mass index or waist circumference significantly attenuated the OCP-NAFLD relationship. Conclusions: In this large US-representative population, OCP use was associated with reduced odds of NAFLD. However, this association could be mediated or confounded by adiposity. Prospective studies are needed to further clarify the causal role of sex hormone.
KW - Adiposity
KW - Nonalcoholic fatty liver disease
KW - Obesity
KW - Oral contraceptive pill
KW - Sex hormone
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U2 - 10.1007/s00535-012-0715-8
DO - 10.1007/s00535-012-0715-8
M3 - Article
C2 - 23188092
AN - SCOPUS:84892830656
SN - 0944-1174
VL - 48
SP - 1151
EP - 1159
JO - Journal of Gastroenterology
JF - Journal of Gastroenterology
IS - 10
ER -