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1304A AASLD ABSTRACTS HEPATOLOGY, October, 2015 2252 Testosterone Is Associated with Biochemical Markers of Non Alcoholic Fatty Liver Disease (NAFLD) in Women With Polycystic Ovarian Syndrome (PCOS) Monika Sarkar, Chia-Ning Kao, Norah Terrault, Phyllis Tien, Ruth Greenblatt, Marcelle I. Cedars, Heather Huddleston; University of California, San Francisco, San Francisco, CA Background: Non-alcoholic fatty liver disease (NAFLD) affects at least half of all women with PCOS. This may relate to the high prevalence of insulin resistance (IR) and obesity in PCOS. PCOS is also characterized by hyperandrogenism although it is unclear whether this resting high androgen state further promotes worsening NAFLD in PCOS. Methods: This is a cross sectional study of women without heavy alcohol use and with confirmed PCOS (n=149) based on established Rotterdam Criteria, evaluated in a multidisciplinary PCOS clinic between 2006-2014. We aimed to determine if total testosterone is associated with elevated ALT as a marker of NAFLD, after adjusting for age, body mass index (BMI) and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). Linear regression was used to evaluate the association between total testosterone and ALT levels, with point estimates reflecting beta coefficients. Results: The mean age was 28.4 (+/-6.6), median BMI was 28.5 (IQR 24.1-36.0), and median HOMA-IR was 1.9, (IQR 1.0-4.7). Median ALT was 21 (IQR 14-32) and half of women had ALT > 1.5 times upper limits (>29 U/L). Median total testosterone was 54ng/dL (IQR 40-66). On unadjusted analysis, total testosterone was positively associated with ALT (beta coefficient 0.1047, 95% CI 0.0023-0.207, p=0.045) with stronger association after adjusting for age, BMI, and HOMA-IR (beta coefficient 0.1152, 95% CI 0.016-0.21, p=0.02). Increasing BMI (beta coefficient 0.576, 95% CI 0.18- 0.005, p=0.005), but not HOMA-IR (beta coefficient 0.0227, 95% CI -0.122-0.575, p=0.2) was also independently associated with elevated ALT. Conclusion: Elevated ALT levels, a biochemical marker of NAFLD, is common in women with PCOS. Total testosterone was associated with increasing ALT, independent of BMI and insulin resistance. These findings support an important role of androgens as a potential mediator of risk for NAFLD in PCOS, which may offer potential targets for NAFLD treatment in this high-risk population. Disclosures: Norah Terrault - Advisory Committees or Review Panels: Eisai, Biotest; Consulting: BMS, Merck, Achillion; Grant/Research Support: Eisai, Biotest, Vertex, Gilead, AbbVie, Novartis, Merck The following authors have nothing to disclose: Monika Sarkar, Chia-Ning Kao, Phyllis Tien, Ruth Greenblatt, Marcelle I. Cedars, Heather Huddleston 2253 Prevalence of hepatic steatosis in healthy health care workers as quantified by controlled attenuation parameter (CAP) Anita Arslanow, Frank Lammert, Caroline S. Stokes; Department of Medicine II, Saarland University Medical Center, Homburg, Germany Background: Hepatic fat accumulation is the hallmark of non-alcoholic fatty liver (NAFL), for which prevalence estimates range widely from 5 to 50% in the population due to differences of screening and detection strategies. Since up to 25% of patients with NAFLD might develop advanced liver fibrosis and cirrhosis, which increase the risk of liver-associated mortality, better NAFL screening strategies are needed. Our aim was to assess the frequency of hepatic steatosis in participants without a history of chronic liver disease who were recruited from the Occupational Health Department at Saarland University Medical Center. Methods: For this prospective study, 81 participants volunteered (80% women, median age 29 years, range 21 – 63 years). Hepatic steatosis was assessed using controlled attenuation parameter (CAP), which quantifies the degree of ultrasound attenuation based on vibration- controlled transient elastography (VCTE; Fibroscan). Body composition was determined using an eight electrode bioelectrical impedance analyzer (BIA). Liver function tests (LFT) and serum lipid concentrations were measured with standard clinical assays. Results: The median CAP score was 226 dB/m (range 100 – 400 dB/m). In total, 33 participants (41%) presented with hepatic steatosis, when using 238 dB/m as cut-off for liver fat accumulation (Sasso Ultrasound Med Biol 2010). The median body mass index was significantly (P < 0.001) higher in participants with than without liver steatosis (26 vs. 22 kg/m 2 , respectively) and accordingly, the majority of NAFL patients were overweight (42%) or obese (15%). In contrast, only 15% of participants without hepatic steatosis were overweight, and none was obese (P < 0.0001). In line with these associations, body fat mass as determined by BIA was elevated in 48% of participants with hepatic steatosis, as compared to only 6% in those with low liver fat contents. In contrast, LFT and serum lipid parameters did not differ significantly between the two groups. Conclusions: Presence of hepatic steatosis was documented in almost half of this cohort of perceived healthy individuals. Whereas serum surrogate markers did not differentiate the individuals, body composition reflected the differences in liver fat contents among the two groups. CAP (and BIA) represent rapid non-invasive methods that facilitate the identification of fatty liver. Broad NAFL screening in the workplace might be encouraged, since it may allow timely detection of at risk individuals and early implementation of lifestyle changes. Disclosures: The following authors have nothing to disclose: Anita Arslanow, Frank Lammert, Caroline S. Stokes 2254 Assessment of parameters related to choline metabolism in non-alcoholic fatty liver disease: a comparison with healthy controls Hannah Da Silva 1,2 , Bianca M. Arendt 1 , Anastasia Teterina 1 , Sandra E. Fischer 3 , Scott Fung 4 , Johane P. Allard 4 ; 1 Gastroenterology, Toronto General Hospital, Toronto, ON, Canada; 2 Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada; 3 Pathology, Toronto General Hospital, Toronto, ON, Canada; 4 Medicine, Toronto General Hospital, Toronto, ON, Canada Background/Objectives: Choline deficient diets promote steatosis similar to non-alcoholic fatty liver disease (NAFLD). Thus, one of the proposed mechanisms for NAFLD pathogenesis is reduced choline bioavailability resulting from the metabolism of dietary choline to trimethylamine (TMA) by gut micriobiota, causing subsequent reduction of phosphatidylcholine in the liver and decrease in VLDL export of triglycerides. The validity of this proposed mechanism was tested in animal models, but data on choline metabolism in general NAFLD population and its relation to intestinal microbiota is lacking. Our objective was to assess parameters related to choline metabolism and determine whether these parameters are associated with NAFLD. Methods: We studied serum choline and fecal choline and TMA in 39 biopsy-confirmed patients (15 simple steatosis (SS), 24 non-alcoholic steatohepatitis (NASH)), and 28 living liver donors as healthy controls (HC) by nuclear magnetic resonance spectroscopy. Clinical, biochemical, and anthropometric data were also collected. Dietary intake was assessed using a 7-day food record in a subset of participants (10 SS, 20
HEPATOLOGY, VOLUME 62, NUMBER 1 (SUPPL) AASLD ABSTRACTS 1305A NASH, 25 HC). The data are presented as median (Q1, Q3) for non-normal and mean (SD) for normal continuous variables. Groups were compared using Wilcoxon rank-sum tests and t-tests. Spearman correlation coefficients were used to examine association between variables. Results: NAFLD patients were older than HC and had significantly higher BMI, liver enzymes (AST, ALT), insulin resistance (HOMA-IR), hemoglobin A1c, and blood triglycerides (p
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1354A AUTHOR INDEX HEPATOLOGY, Octo
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1366A CATEGORY INDEX HEPATOLOGY, Oc
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