According to data presented at the Endocrine Society’s annual conference (ENDO 2026), a high prevalence of steatotic liver disease has been observed in young women with polyendocrine metabolic ovarian syndrome (PMOS).
Research Findings
The study included 95 patients (mean age 31.2 years; mean BMI 29.1) who presented to an endocrinology clinic for PMOS evaluation. The majority of participants were overweight or obese and met the Rotterdam criteria for PMOS. Steatosis was diagnosed in 42.1% of participants, and 95% of those with steatosis met the criteria for metabolic dysfunction-associated steatotic liver disease (MASLD).
The results confirm that the development of steatosis correlates with age, higher BMI, elevated leukocyte counts, metabolic syndrome markers, insulin resistance, and manifestations of hyperandrogenism. Notably, the frequency of steatosis did not differ statistically between patients with and without a formal PMOS diagnosis, suggesting that these metabolic risks may extend beyond the scope of PMOS alone.
Challenges in Fibrosis Screening
The study identified liver fibrosis in 6.3% of participants, yet standard non-invasive methods failed to detect it. Specifically, the Fibrosis-4 (FIB-4) index proved uninformative for the majority of patients due to low sensitivity. While the Steatotic Liver Disease Fibrosis Score (SAFE) showed relatively better performance, it also failed to capture all cases. The authors concluded that existing diagnostic tools are insufficiently accurate for this specific age group.
This is clinically critical, as young women with PMOS often remain undertreated because traditional screening tools are not adapted to their specific age group and metabolic profile. Although the authors recommend incorporating FibroScan for patients with high BMI or hyperandrogenism, determining the optimal strategy for detecting early liver damage remains an ongoing challenge.
This study confirms that PMOS is not merely a reproductive-endocrine syndrome; it carries a significant metabolic burden that increases the risk of liver disease. The frequent manifestation of hyperandrogenism in patients with steatosis suggests that androgens may play a leading role in the pathogenesis of fatty liver disease, potentially similar to the role of insulin resistance.
The message for clinicians is clear: diagnosing fatty liver disease should be a priority in young women with PMOS, particularly in the presence of metabolic comorbidities. Since current screening methods are frequently unreliable in this population, the development of more precise, age-adapted diagnostic approaches is essential.
Source: Medscape
