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MASLD coexisting with PCOS increases cardiometabolic risk.

Oyekoya T Ayonrinde1,2,3, Trevor A Mori1, Leon A Adams1

  • 1Medical School, The University of Western Australia, Nedlands, WA 6009, Australia.

The Journal of Clinical Endocrinology and Metabolism
|January 13, 2026
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Summary
This summary is machine-generated.

Polycystic ovary syndrome (PCOS) combined with metabolic dysfunction-associated steatotic liver disease (MASLD) in adolescence predicts adult obesity and insulin resistance. PCOS alone does not increase these risks.

Keywords:
Raine studyinsulin resistancemetabolic dysfunction-associated steatotic liver diseaseobesitypolycystic ovary syndrometestosterone

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Area of Science:

  • Endocrinology
  • Hepatology
  • Cardiology

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) and polycystic ovary syndrome (PCOS) are common in reproductive-aged women.
  • Both MASLD and PCOS are linked to increased long-term cardiometabolic risks.

Purpose of the Study:

  • To investigate if co-existing PCOS and MASLD (PCOS+MASLD) in adolescent females predicts greater cardiometabolic risk factors at age 27 compared to either condition alone.
  • To assess the 10-year cardiometabolic outcomes in adolescents with PCOS+MASLD within the Raine Study cohort.

Main Methods:

  • Retrospective diagnosis of PCOS (age 14) and MASLD (age 17) in 199 female adolescents from the Raine Study.
  • Assessments included anthropometry, blood tests, and ultrasounds.
  • Follow-up at age 27 included anthropometry, cardiovascular, and fasting blood assessments in 148 participants.

Main Results:

  • At age 17, 10.1% had PCOS+MASLD, associated with obesity and adverse lipid profiles.
  • By age 27, adolescents with adolescent PCOS+MASLD showed significantly higher insulin resistance, remnant lipoprotein cholesterol, and triglyceride/HDL cholesterol ratio.
  • PCOS without MASLD or obesity in adolescence did not predict future insulin resistance.

Conclusions:

  • Adolescent PCOS+MASLD significantly increases the likelihood of adult obesity and insulin resistance.
  • PCOS alone in adolescence does not predict future adverse cardiometabolic phenotypes.
  • Early identification and management of co-existing PCOS and MASLD in adolescents are crucial for preventing long-term cardiometabolic complications.