Oral contraceptive pill use is associated with reduced odds of nonalcoholic fatty liver disease in menstruating women: results from NHANES III.

MedStar author(s):
Citation: Journal of Gastroenterology. 48(10):1151-9, 2013 Oct.PMID: 23188092Institution: MedStar Washington Hospital CenterDepartment: Medicine/GastroenterologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Contraceptives, Oral/ad [Administration & Dosage] | *Fatty Liver/ep [Epidemiology] | *Liver/pa [Pathology] | *Menstruation | Adult | Cross-Sectional Studies | Fatty Liver/us [Ultrasonography] | Female | Humans | Liver/us [Ultrasonography] | Middle Aged | Prevalence | Risk Factors | United States | Young AdultLocal holdings: Available online through MWHC library: 1998 - 2010ISSN:
  • 0944-1174
Name of journal: Journal of gastroenterologyAbstract: 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.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.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 NAFLD 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.All authors: Bonekamp S, Clark JM, Hernaez R, Kao WH, Koteish A, Lazo M, Liu SH, Shih MHDigital Object Identifier: Date added to catalog: 2014-08-21
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article Available 23188092

Available online through MWHC library: 1998 - 2010

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.

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.

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 NAFLD 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.

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