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Long or irregular menstrual cycles and risk of prevalent and incident non-alcoholic fatty liver disease

Long or irregular menstrual cycles and risk of prevalent and incident non-alcoholic fatty liver disease
Long or irregular menstrual cycles and risk of prevalent and incident non-alcoholic fatty liver disease
Context: The association of menstrual cycle length and irregularity with the risk of non-alcoholic fatty liver disease (NAFLD) is unknown.

Objective: We examined this association in large cross-sectional and cohort studies.

Methods: The cross-sectional study included 72 092 women younger than 40 years who underwent routine health examinations; the longitudinal analysis included the subset of 51 118 women without NAFLD at baseline. Long or irregular cycles were defined as menstrual cycles of 40 days or longer or too irregular to estimate. Abdominal ultrasonography was performed to identify NAFLD. Multivariable Cox proportional hazard regression analyses were performed to estimate hazard ratios (HRs) and 95% CIs for incident NAFLD according to menstrual cycle regularity and length, with 26- to 30-day cycles as the reference.

Results: At baseline, 27.7% had long or irregular menstrual cycles and 7.1% had prevalent NAFLD. Long or irregular menstrual cycles were positively associated with prevalent NAFLD. During a median follow-up of 4.4 years, incident NAFLD occurred in 8.9% of women. After adjustment for age, body mass index, insulin resistance, and other confounders, the multivariable-adjusted HR for NAFLD comparing long or irregular menstrual cycles to the reference group was 1.22 (95% CI, 1.14-1.31); this association strengthened in the time-dependent analysis with an HR of 1.49 (95% CI, 1.38-1.60).

Conclusion: Long or irregular menstrual cycles were associated with increased risk of both prevalent and incident NAFLD in young, premenopausal women. Women with long or irregular menstrual cycles may benefit from lifestyle modification advice to reduce the risk of NAFLD and associated cardiometabolic diseases.


cohort study, menstrual irregularity, menstruation, nonalcoholic fatty liver disease
0021-972X
e2309-e2317
Cho, In Young
11fd3d46-e614-4f03-8249-86858bf5ded3
Chang, Yoosoo
f24a30a5-258f-4a25-b5fa-205d4d7f0a09
Kang, Jae-Heon
a3881428-e879-48be-a1ac-2c0f24382aaf
Kim, Yejin
362ac095-71f3-4093-9db1-0b09f4aed36a
Sung, Eunju
0e40a07f-55e0-4980-97e3-3293f51de4a0
Shin, Hocheol
b29e1f3d-5462-4c39-b379-45032ec9f9a3
Wild, Sarah H.
b9651617-5b3b-4b6b-8d7e-b4bb95e3b927
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
2ca5883c-73aa-4f4d-ba58-69d8cb507fbf
Cho, In Young
11fd3d46-e614-4f03-8249-86858bf5ded3
Chang, Yoosoo
f24a30a5-258f-4a25-b5fa-205d4d7f0a09
Kang, Jae-Heon
a3881428-e879-48be-a1ac-2c0f24382aaf
Kim, Yejin
362ac095-71f3-4093-9db1-0b09f4aed36a
Sung, Eunju
0e40a07f-55e0-4980-97e3-3293f51de4a0
Shin, Hocheol
b29e1f3d-5462-4c39-b379-45032ec9f9a3
Wild, Sarah H.
b9651617-5b3b-4b6b-8d7e-b4bb95e3b927
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Ryu, Seungho
2ca5883c-73aa-4f4d-ba58-69d8cb507fbf

Cho, In Young, Chang, Yoosoo, Kang, Jae-Heon, Kim, Yejin, Sung, Eunju, Shin, Hocheol, Wild, Sarah H., Byrne, Christopher and Ryu, Seungho (2022) Long or irregular menstrual cycles and risk of prevalent and incident non-alcoholic fatty liver disease. Journal of Clinical Endocrinology & Metabolism, 107 (6), e2309-e2317. (doi:10.1210/clinem/dgac068).

Record type: Article

Abstract

Context: The association of menstrual cycle length and irregularity with the risk of non-alcoholic fatty liver disease (NAFLD) is unknown.

Objective: We examined this association in large cross-sectional and cohort studies.

Methods: The cross-sectional study included 72 092 women younger than 40 years who underwent routine health examinations; the longitudinal analysis included the subset of 51 118 women without NAFLD at baseline. Long or irregular cycles were defined as menstrual cycles of 40 days or longer or too irregular to estimate. Abdominal ultrasonography was performed to identify NAFLD. Multivariable Cox proportional hazard regression analyses were performed to estimate hazard ratios (HRs) and 95% CIs for incident NAFLD according to menstrual cycle regularity and length, with 26- to 30-day cycles as the reference.

Results: At baseline, 27.7% had long or irregular menstrual cycles and 7.1% had prevalent NAFLD. Long or irregular menstrual cycles were positively associated with prevalent NAFLD. During a median follow-up of 4.4 years, incident NAFLD occurred in 8.9% of women. After adjustment for age, body mass index, insulin resistance, and other confounders, the multivariable-adjusted HR for NAFLD comparing long or irregular menstrual cycles to the reference group was 1.22 (95% CI, 1.14-1.31); this association strengthened in the time-dependent analysis with an HR of 1.49 (95% CI, 1.38-1.60).

Conclusion: Long or irregular menstrual cycles were associated with increased risk of both prevalent and incident NAFLD in young, premenopausal women. Women with long or irregular menstrual cycles may benefit from lifestyle modification advice to reduce the risk of NAFLD and associated cardiometabolic diseases.


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More information

Accepted/In Press date: 2 February 2022
e-pub ahead of print date: 3 March 2022
Published date: 1 June 2022
Additional Information: Financial Support This work was supported by the SKKU Excellence in Research Award Research Fund, Sungkyunkwan University, 2020. C.D.B. is supported in part by the Southampton National Institute for Health Research Biomedical Research Centre (No. IS-BRC-20004), UK.
Keywords: cohort study, menstrual irregularity, menstruation, nonalcoholic fatty liver disease

Identifiers

Local EPrints ID: 456988
URI: http://eprints.soton.ac.uk/id/eprint/456988
ISSN: 0021-972X
PURE UUID: 726bdf57-6d72-495c-b5a8-fc2529556f7e
ORCID for Christopher Byrne: ORCID iD orcid.org/0000-0001-6322-7753

Catalogue record

Date deposited: 19 May 2022 16:32
Last modified: 30 Sep 2022 01:36

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Contributors

Author: In Young Cho
Author: Yoosoo Chang
Author: Jae-Heon Kang
Author: Yejin Kim
Author: Eunju Sung
Author: Hocheol Shin
Author: Sarah H. Wild
Author: Seungho Ryu

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