Effect of goserelin acetate on non-invasive indices of hepatic steatosis in women with endometriosis

Abstract Purpose Menopause has been associated with metabolic dysfunction-associated steatotic liver disease (MASLD). This study primarily aimed to evaluate changes in non-invasive indices of hepatic steatosis in premenopausal women with endometriosis after treatment with goserelin resulting in pharmacologic menopause. Methods This was a post-hoc study of an interventional study. Non-invasive indices of hepatic steatosis and, secondarily, fibrosis were calculated in premenopausal women with endometriosis (intervention group, n = 21) before (baseline), 6 months after goserelin treatment (estrogen-deficient period), and 6 months after goserelin discontinuation (estrogen replenishment period). Matched premenopausal women were recruited for baseline comparisons (control group, n = 27). Steatosis was evaluated using the Hepatic Steatosis Index (HSI), Triglyceride/Glucose Index (TyG), TyG-Body Mass Index (BMI), Triglyceride/High Density Lipoprotein (TG/HDL), Metabolic Score for Insulin Resistance (MetS-IR), Dallas Steatosis Index (DSI), and Framingham Steatosis Index (FSI), and fibrosis with BMI – Aspartate Aminotransferase (AST)/Alanine Aminotransferase (ALT) Ratio Diabetes Mellitus (BARD). Results The non-invasive indices of hepatic steatosis and BARD were similar between patients and controls at baseline and did not significantly change after goserelin treatment, except for MetS-IR, which showed an overall significant change (p = 0.04); however, in pairwise comparisons after Bonferroni correction, no significant difference in MetS-IR was observed between baseline (34.8 ± 7.7), month 6 (33.3 ± 9.0), and endpoint (35.0 ± 8.1) values. As expected, the lipid profiles and insulin resistance worsened during the study. Conclusion Non-invasive hepatic steatosis and BARD indices were not significantly affected by estrogen deficiency caused by 6-month goserelin treatment in premenopausal women with endometriosis.