Adiponectin and Polycystic Ovary Syndrome in Adolescent Girls: A Systematic Review and Meta-Analysis

Polycystic ovary syndrome (PCOS) is a prevalent endocrine-metabolic disorder affecting 5.5-11.5% of women of reproductive age. While reduced adiponectin levels have been consistently demonstrated in adult women with PCOS, findings in adolescents remain less clearly defined. A systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. PubMed, Embase, Scopus, and Google Scholar were searched from inception to 31 October 2025. Observational studies comparing adiponectin levels in post-pubertal adolescents with PCOS and controls were included. Data were pooled using random-effects meta-analysis in RStudio, with subgroup, sensitivity, heterogeneity, and publication bias analyses conducted. Eighteen studies comprising 1590 participants were analyzed. The pooled analysis demonstrated significantly lower adiponectin levels in adolescents with PCOS compared to controls (mean difference [MD]: -3.19 µg/mL; 95% CI: -4.90 to -1.49; p = 0.0010), with substantial heterogeneity (I² > 90%). Subgroup analyses by diagnostic criteria, geographic region, study design, and weight status consistently showed reduced adiponectin levels in PCOS, with no significant subgroup differences. In conclusion, adolescents with PCOS exhibit significantly lower adiponectin levels, consistent with findings in adult populations. These results support an early association between adiponectin dysregulation and PCOS, although further longitudinal studies are needed to clarify clinical utility.