Sheran P. W. Fernando

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.

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 con-sistently 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 October 31, 2025. Observational studies comparing adiponectin levels in post-pubertal adolescents with PCOS and controls were included. A random-effects model with REML estimator was applied. Study heterogeneity and publication bias were as-sessed. Eighteen studies comprising 1,590 participants (679 PCOS; 911 controls) were in-cluded. Adolescents with PCOS demonstrated significantly lower adiponectin levels com-pared to controls (mean difference [MD] −3.17 µg/mL; 95% CI −4.27 to −2.07; p = 0.001), I² = 94.6%. Egger’s (p = 0.81) and Begg’s (p = 0.16) tests indicated no evidence of publication bias. Adolescents with PCOS exhibit significantly reduced circulating adiponectin levels, suggesting that adipose tissue dysfunction and metabolic dysregulation are present early in the disease course. These findings support the role of adiponectin as a potential early biomarker of cardiometabolic risk in adolescent PCOS and underscore the importance of early metabolic screening and intervention.