Divergent fat deposition in PCOS: A preliminary comparative analysis of pancreatic and hepatic steatosis in aging clinical and unselected populations.

OBJECTIVE

This study investigated differences in hepatic and pancreatic fat accumulation between clinically referred and unselected patients with polycystic ovary syndrome, in comparison with healthy controls matched for age and body mass index.

METHODS

In this pilot study, a hospital-based cohort comprised 34 women with polycystic ovary syndrome and 32 controls, and an unselected cohort comprised 28 women with polycystic ovary syndrome and 29 controls, all over 35 years of age. Clinical and metabolic assessments were performed, and hepatic and pancreatic fat content was measured using magnetic resonance imaging proton density fat fraction %.

RESULTS

Patients with polycystic ovary syndrome in the hospital-based cohort exhibited significantly higher body mass index (29.0 ± 4.5 vs. 25.0 ± 4.0 kg/m2, p < 0.001), free androgen index (p < 0.001), and hepatic fat percentage (p = 0.02) compared with those -in the unselected cohort. Hepatic fat was associated with free androgen index after adjustment for body mass index (p = 0.02). In contrast, pancreatic head fat was associated with metabolic parameters and was significantly higher in hospital-based patients with polycystic ovary syndrome compared with both their matched hospital controls (p = 0.03) and unselected patients with polycystic ovary syndrome (p = 0.009). These results indicate differing patterns of association for hepatic and pancreatic fat in polycystic ovary syndrome.

CONCLUSIONS

As an exploratory investigation, our findings demonstrate that the distribution of hepatic and pancreatic fat in polycystic ovary syndrome is associated with distinct metabolic and hormonal profiles, with differences evident between unselected and hospital-referred populations. These observations highlight the need to consider recruitment setting in clinical evaluations and support the role of obesity management in reducing organ-specific fat accumulation.