Link between fatty liver disease, hot flash severity ‘hard to tease apart’

Key takeaways:

• Midlife women with a diagnosis of fatty liver disease had more severe hot flashes in initial analyses.
• This association became insignificant when adjusting for BMI and hypertension.

Midlife women with a metabolic dysfunction-associated steatotic liver disease diagnosis were more likely to report severe or very severe hot flashes, though researchers found no direct link between the two conditions, data show.

“We can’t say that a diagnosis of fatty liver was associated with hot flashes and night sweats,” Stephanie S. Faubion, MD, MBA, MSCP, director of the Mayo Clinic Center for Women’s Health and medical director of The Menopause Society, told Healio. “There are probably some limitations to our data. You only get a diagnosis of fatty liver if you go to a doctor and they happen to do an ultrasound of your liver and they happen to find fat in it, so the prevalence of fatty liver is probably higher in real life than it was in our population, and we were not able to capture everyone that actually has a fatty liver.”

Faubion and colleagues conducted a cross-sectional study distributing surveys to 4,599 women (mean age, 54.1 years) aged 45 to 60 years who received primary care at one of four Mayo Clinic sites in the U.S. from March through June 2021. Fifty-five percent of women were postmenopausal and 95% were white. Researchers obtained metabolic dysfunction-associated steatotic liver disease (MASLD) diagnoses via medical records and evaluated vasomotor symptom burden using the Menopause Rating Scale, categorized as severe or very severe or none/mild/moderate.

The findings were published in Menopause.

Overall, 7% of women had MASLD; those with a diagnosis were also more likely to have CV risk factors such as obesity, type 2 diabetes, hyperlipidemia and hypertension.

Women with MASLD were more likely to have severe or very severe vasomotor symptoms compared with women without the diagnosis in the univariate analysis (OR = 1.5; 95% CI, 1.08-2.08; P = .015) and after additional adjustment for multiple factors including current hormone therapy use, type 2 diabetes status and hyperlipidemia. However, the researchers noted, the association between MASLD and vasomotor symptom severity was no longer statistically significant after individually adjusting for BMI and hypertension.

Researchers noted after adjusting for the association between MASLD diagnosis and vasomotor symptoms by both BMI and hypertension, hypertension was an independent predictor of severe or very severe vasomotor symptoms (adjusted OR, 1.25; 95% CI, 1.01-1.56; P = .04).

“We need larger numbers of women [and to] make sure that we had women who were followed in an MASLD clinic with the diagnosis already made, and then look and see what their hot flashes are compared with women who did not have fatty liver,” Faubion told Healio. “It’s going to be hard to tease that apart, because you don’t always know when women have fatty liver.”

For more information:

Stephanie S. Faubion, MD, MBA, MSCP, can be reached at faubion.stephanie@mayo.edu.