Polycystic ovary syndrome (PCOS) has metabolic implications during adolescence, including among individuals within the normal body mass index (BMI) range. This study evaluated visceral adipose tissue (VAT) thickness and lipid-related metabolic markers in normal-weight adolescents with PCOS. In this cross-sectional case–control study based on prospectively collected standardized data, adolescents aged 13–19 years with BMI percentiles within the normal range were included. Twenty-nine adolescents with PCOS diagnosed according to international adolescent-specific criteria and 31 age-matched healthy controls were analyzed. VAT thickness was assessed by abdominal ultrasonography. Fasting glucose, insulin, lipid parameters, HOMA-IR, and HOMA-β were evaluated. Correlation, multivariable regression, BMI percentile-adjusted, and exploratory sensitivity analyses were performed. Adolescents with PCOS had higher BMI percentiles than controls, although all participants were normal-weight. VAT thickness, triglyceride levels, and TG/HDL-C ratio were higher in the PCOS group in unadjusted analyses. After adjustment for BMI percentile, VAT thickness remained significantly higher, whereas the TG/HDL-C difference was attenuated and no longer statistically significant. Fasting insulin and HOMA-IR did not differ between groups, whereas HOMA-β was higher in adolescents with PCOS. VAT thickness was independently associated with the TG/HDL-C ratio in the PCOS group. In the overall cohort, VAT thickness and waist circumference, but not BMI percentile or group status, were associated with the TG/HDL-C ratio.Conclusion: Normal-weight adolescents with PCOS showed greater visceral adiposity than controls. Triglycerides and the TG/HDL-C ratio should be interpreted cautiously as complementary exploratory lipid-related markers associated with visceral adiposity, rather than as definitive or superior predictors.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> What is Known: • Polycystic ovary syndrome in adolescence is associated with metabolic alterations, particularly in individuals with overweight or obesity. • Normal-weight adolescents with PCOS may also show metabolic vulnerability, but data on visceral adiposity and lipid-related markers in this subgroup remain limited. </entry> </row> <row> <entry nameend="c2" namest="c1"> What is New: • Normal-weight adolescents with PCOS showed greater ultrasonographically assessed visceral adipose tissue thickness than controls, and this difference persisted after adjustment for BMI percentile. • Lipid-related markers, including triglycerides and the TG/HDL-C ratio, were exploratory and should be interpreted cautiously in relation to visceral adiposity. </entry> </row> </tbody> </tgroup> </Table>

Visceral adiposity and lipid-related metabolic markers in normal-weight adolescent girls with polycystic ovary syndrome

期刊论文
发表日期：

2026年7月27日

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Neşe Hayırlıoğlu,
Nurşen Kurtoğlu

摘要

Polycystic ovary syndrome (PCOS) has metabolic implications during adolescence, including among individuals within the normal body mass index (BMI) range. This study evaluated visceral adipose tissue (VAT) thickness and lipid-related metabolic markers in normal-weight adolescents with PCOS. In this cross-sectional case–control study based on prospectively collected standardized data, adolescents aged 13–19 years with BMI percentiles within the normal range were included. Twenty-nine adolescents with PCOS diagnosed according to international adolescent-specific criteria and 31 age-matched healthy controls were analyzed. VAT thickness was assessed by abdominal ultrasonography. Fasting glucose, insulin, lipid parameters, HOMA-IR, and HOMA-β were evaluated. Correlation, multivariable regression, BMI percentile-adjusted, and exploratory sensitivity analyses were performed. Adolescents with PCOS had higher BMI percentiles than controls, although all participants were normal-weight. VAT thickness, triglyceride levels, and TG/HDL-C ratio were higher in the PCOS group in unadjusted analyses. After adjustment for BMI percentile, VAT thickness remained significantly higher, whereas the TG/HDL-C difference was attenuated and no longer statistically significant. Fasting insulin and HOMA-IR did not differ between groups, whereas HOMA-β was higher in adolescents with PCOS. VAT thickness was independently associated with the TG/HDL-C ratio in the PCOS group. In the overall cohort, VAT thickness and waist circumference, but not BMI percentile or group status, were associated with the TG/HDL-C ratio.

Conclusion: Normal-weight adolescents with PCOS showed greater visceral adiposity than controls. Triglycerides and the TG/HDL-C ratio should be interpreted cautiously as complementary exploratory lipid-related markers associated with visceral adiposity, rather than as definitive or superior predictors.

What is Known:

• Polycystic ovary syndrome in adolescence is associated with metabolic alterations, particularly in individuals with overweight or obesity.

• Normal-weight adolescents with PCOS may also show metabolic vulnerability, but data on visceral adiposity and lipid-related markers in this subgroup remain limited.

What is New:

• Normal-weight adolescents with PCOS showed greater ultrasonographically assessed visceral adipose tissue thickness than controls, and this difference persisted after adjustment for BMI percentile.

• Lipid-related markers, including triglycerides and the TG/HDL-C ratio, were exploratory and should be interpreted cautiously in relation to visceral adiposity.