Adiponectin and Polycystic Ovary Syndrome in Adolescent Girls: A Systematic Review and Meta-Analysis

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.