Oral menopausal hormone therapy associated with increased risk of NAFLD

Non-alcoholic fatty liver disease (NAFLD) is characterized by extensive accumulation of fat and triglycerides in the liver and is not caused by excessive alcohol or drug use. NAFLD is the most common chronic liver disease, and the prevalence in postmenopausal women is greater than 20% worldwide. Although the prevalence of NAFLD differs based on age, sex, menopausal status, region, time, diagnostic tool, and definition, the incidence of NAFLD continues to increase. Furthermore, NAFLD can progress to more serious conditions such as cirrhosis and hepatocellular carcinoma; however, an established treatment does not exist. Therefore, NAFLD has clinical importance and should be further investigated.

The effects of menopausal hormone therapy (MHT) on non-alcoholic fatty liver disease (NAFLD) were compared based on the route of estrogen administration. The study included 368 postmenopausal women who received MHT for 12 months. Patients were divided into transdermal (n = 75) and oral (n = 293) groups based on the estrogen route. Changes in the prevalence of NAFLD were compared between the two groups before and after 12 months of MHT. In addition, differences in the progression of NAFLD after MHT based on the dose of estrogen and type of progestogen were evaluated in the oral group. After MHT, the prevalence of NAFLD decreased from 24 to 17.3% in the transdermal group but increased from 25.3 to 29.4% in the oral group. Little or no change was found in clinical characteristics and laboratory tests in the transdermal group during MHT. However, serum levels of total cholesterol and low-density lipoprotein cholesterol decreased and triglycerides and high-density lipoprotein cholesterol increased significantly in the oral group. Furthermore, changes in the prevalence of NAFLD were not significantly different based on the dose of estrogen or type of progestogen.

The findings indicate that transdermal estrogen can be beneficial in terms of NAFLD progression.

Reference:

Kim, S.E., Min, JS., Lee, S. et al. Different effects of menopausal hormone therapy on non-alcoholic fatty liver disease based on the route of estrogen administration. Sci Rep 13, 15461 (2023). https://doi.org/10.1038/s41598-023-42788-6

Keywords:

Kim, S.E., Min, JS., Lee, S, Different, effects, menopausal, hormone, therapy, non-alcoholic, fatty, liver disease, route, estrogen, administration