MASLD coexisting with PCOS increases cardiometabolic risk

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.