Pancreatic body and hepatic fat content predict impaired glucose regulation in women with polycystic ovary syndrome

Abstract Context Women with polycystic ovary syndrome (PCOS) are more prone to glucose metabolism abnormalities, likely due to increased visceral adiposity. Objective This study aimed to investigate the association of pancreatic and hepatic fat content with glucose metabolism in PCOS. Design and Setting This study included 160 women with PCOS. All participants underwent an oral glucose tolerance test. Magnetic resonance imaging - derived proton density fat fraction was used to measure fat content in different visceral organs. Results Pancreatic interlobular fat volume, pancreatic body fat and hepatic fat were significantly higher in PCOS with diabetes than in those with normal glucose tolerance (P < 0.05). Elevated pancreatic body fat [OR 2.21 (95% CI 1.01 - 4.85), P = 0.047] and hepatic average fat [OR 2.92 (95% CI 1.13 - 7.51), P = 0.026] were independently associated with higher impaired glucose regulation (IGR) risks. Only patients with elevated levels of both pancreatic body fat and hepatic average fat exhibited increased risk of IGR after multiple confounding adjustments [OR 5.49 (95% CI 1.63 - 18.47), P = 0.006]. The hepatic average fat to pancreatic body fat ratio lost its significant association with IGR risk after multivariable adjustment (P = 0.705). The combination of pancreatic body fat and hepatic average fat with traditional risk factors (age, BMI, WHR, TG and FAI) demonstrated a trend toward improved predictive performance for IGR, with the highest AUC (0.789) observed. Conclusions Pancreatic body and hepatic fat content predict IGR and synergistically regulate glucose metabolism in PCOS.