DAY 1: Polyendocrine Metabolic Ovarian Syndrome Increases Risk for Steatotic Liver Disease In Women

An analysis presented at the 2026 Annual Scientific Meeting of the American College of Gastroenterology in Nashville, Tennessee revealed that polyendocrine metabolic ovarian syndrome (PMOS) significantly increases the risk of developing metabolic dysfunction-associated steatohepatitis (MASH) and associated complications.

Previous research has shown that PMOS and metabolic dysfunction-associated steatotic liver disease are interconnected metabolic disorders driven by overlapping risk factors [Graef A et al. Nutrients 2026;18:1948]. Shared metabolic disturbances, such as central obesity, dyslipidemia, and systemic inflammation, accelerate the progression from steatosis to MASH and fibrosis. “The ovary-liver axis describes how sex hormones regulate body fat distribution and glucose-lipid metabolism, and this is closely tied to fat accumulation in the liver in women,” said presenting author Shruti Jain, MBBS, a resident at Louisiana State University Health. “Polycystic ovarian syndrome (PCOS), recently renamed polyendocrine metabolic ovarian syndrome (PMOS), is the most common endocrine disorder in reproductive-aged women. It is characterized by insulin resistance, hyperandrogenism, and ovarian dysfunction. These [disturbances] overlap heavily with the pathophysiology of MASH.”

Jain and colleagues analyzed the records of nearly 110,000 women diagnosed with PCOS/PMOS and compared them to data obtained from an equal number of propensity-matched women without endocrine disorders.

The analysis, which excluded patients with preexisting liver disease, showed that women with PCOS/PMOS had more than double the risk of developing MASH, as well as a significantly higher risk of MASH-related cirrhosis and decompensated cirrhosis compared with their counterparts without PCOS/PMOS. The odds of developing hepatocellular carcinoma or needing a liver transplant were also higher for the group with PCOS/PMOS, but those did not reach statistical significance, likely due to the limited number of events, Jain specified.

“This large propensity-matched analysis shows that PCOS is an important, underrecognized risk [factor] for MASH,” Jain added. “Further, prospective studies are needed to see whether PCOS-directed therapies can actually improve liver outcomes.” The author pointed out that hepatology screening protocols should be considered for women with PCOS/PMOS.