Loading
Life sciences · Journal article
BMC Women S Health · October 1, 2026
No summary has been generated for this record yet. What follows is drawn from its source metadata only.
Journal article.
No findings were extractable from the material analysed.
Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.
The source did not state who this applies to in practice.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
This record has not been graded across any dimension yet. Treat the label above as provisional and read the source.
What is missing. This record has no bottom line, key findings, reported figures, evidence dimensions. That is a gap in the analysis, not a judgement about the study.
Polycystic ovary syndrome (PCOS), recently renamed polyendocrine metabolic ovarian syndrome, is a heterogeneous endocrine and metabolic disorder. Metabolic risk is commonly assessed using body mass index (BMI); however, this approach may not adequately reflect metabolic differences among East Asian women, many of whom are non-obese. We aimed to identify body composition-based patterns in Japanese women with polycystic ovary syndrome and characterize their metabolic and endocrine features beyond BMI. This multicenter cross-sectional study included 314 women undergoing initial fertility evaluation, comprising 112 women with PCOS and 202 non-PCOS infertility controls. Body composition was assessed using bioelectrical impedance analysis. Among women with PCOS, eight body composition variables representing adiposity, muscle mass, and regional body composition were analyzed using principal component analysis followed by Ward hierarchical clustering. Endocrine and glycometabolic characteristics were compared across the identified clusters and with the controls. Three body composition-based clusters were identified among women with PCOS: a fat-reduced lean cluster (CL1; n = 53, 47.3%), a muscle-reduced lean cluster (CL2; n = 29, 25.9%), and an overweight cluster (CL3; n = 30, 26.8%). Despite similar BMI, the two lean clusters showed distinct body composition, endocrine and metabolic characteristics. CL1 showed reduced adiposity, preserved skeletal muscle, preferential lower-limb muscle distribution, lower FSH levels, and preserved insulin regulation. CL2 showed reduced skeletal muscle mass and preserved FSH levels. Among participants with available HOMA-IR measurements, exploratory findings suggested possible mild impairment of insulin regulation without compensatory hyperinsulinemia. In contrast, CL3 showed greater adiposity, a tendency towards higher testosterone levels, and insulin resistance with overt compensatory hyperinsulinemia. The muscle-reduced phenotype of CL2 persisted after age adjustment and was not reproduced by the same clustering approach in the non-PCOS infertility controls. Body composition-based clustering revealed endocrine and metabolic heterogeneity beyond BMI in Japanese women with PCOS, including distinct phenotypes among lean women with similar BMI. In particular, reduced skeletal muscle mass identified a lean phenotype with possible metabolic vulnerability that was not apparent from BMI alone. These findings highlight skeletal muscle mass and regional body composition, in addition to adiposity, as potentially important features of PCOS heterogeneity and suggest that body composition assessment may complement BMI in metabolic risk evaluation among PCOS women. Not applicable.