Association of progesterone and prolactin with hepatic steatosis in premenopausal women: A prospective cross-sectional study

ABSTRACT This study aimed to investigate the association between hepatic steatosis and serum levels of reproductive hormones in premenopausal women, with particular focus on progesterone and prolactin. A total of 87 premenopausal women aged 18–45 years were included in this prospective study. Participants were classified by ultrasonographic steatosis status and grade. Blood samples obtained on day 3 of the menstrual cycle were used to measure follicle-stimulating hormone, luteinizing hormone, estradiol, progesterone, and prolactin levels. Women with overt metabolic and endocrine disorders were excluded. Multivariable logistic regression and receiver operating characteristic analyses were performed. Hepatic steatosis was present in 53 participants (60.9%), whereas 34 participants had no steatosis. Progesterone and prolactin levels were significantly lower in participants with hepatic steatosis than in those without steatosis (0.6 vs. 1.1 ng/mL and 7.9 vs. 11.0 ng/mL, respectively; both p<0.001). In multivariable analysis, older age (odds ratio: 1.32, 95% confidence interval: 1.12–1.56; p=0.001), higher body mass index (odds ratio: 1.57, 95% confidence interval: 1.19–2.08; p=0.002), lower progesterone levels (odds ratio: 0.75, 95% confidence interval: 0.58–0.98; p=0.037), and lower prolactin levels (odds ratio: 0.51, 95% confidence interval: 0.34–0.79; p=0.002) were independently associated with hepatic steatosis. Estradiol, follicle-stimulating hormone, and luteinizing hormone were not associated with steatosis. Receiver operating characteristic analysis showed a discriminative value for progesterone (area under the curve: 0.751) and prolactin (area under the curve: 0.790). Lower serum progesterone and prolactin levels were associated with hepatic steatosis after adjustment for age and body mass index. These findings support a possible relationship between reproductive hormonal milieu and hepatic steatosis in a selected premenopausal population, while the progesterone finding should be interpreted in the context of early follicular-phase measurement.