SFEBES2026 Poster Presentations Reproductive Endocrinology (14 abstracts)
Circulating leptin levels are higher in lean women with polycystic ovary syndrome than in those with hypothalamic amenorrhoea
Megan Young 1,2 , Kanyada Koysombat 1,3 , Bijal Patel 1,3 , Arthur C. Yeung 1 , Maria Phylactou 1,3 , Jovanna Tsoutsouki 1 , Sandhi Nyunt 1,3 , Aaran H. Patel 1,3 , Aureliane Pierret 1,3 , Elisabeth Daniels 1,3 , Ambreen Qayum 1,3 , Pei Chia Eng 1,3 , Elizaveta Sheremetyeva 1,4 , Edouard Mills 1,3 , Simon Hanassab 1,4 , Channa Jayasena 1,3 , Tricia Tan 1,3 , Sophie A. Clarke 5 , Alexander N. Comninos 1,3 , Ali Abbara 1,3 & Waljit S. Dhillo 1,3
1Department of Metabolism, Digestion and Reproduction, Imperial College London, London, United Kingdom; 2Medicine and Integrated Care, Imperial College Healthcare NHS Trust, London, United Kingdom; 3Department of Endocrinology, Imperial College Healthcare NHS Trust, London, United Kingdom; 4Department of Computing, Imperial College London, London, United Kingdom; 5University College Hospitals NHS Foundation Trust, London, United Kingdom
Background: Leptin, secreted from white adipocytes, links metabolic and reproductive function by acting as a signal of energy sufficiency. Leptin concentrations are proportional to BMI as a surrogate for adiposity. Women with polycystic ovary syndrome (PCOS) often exhibit adipose dysfunction, including hypertrophic white adipocytes and reduced brown adipose activity. In contrast, women with hypothalamic amenorrhoea (HA) have reduced adipose tissue mass. Herein, we examine whether leptin concentrations differ between women with PCOS or HA.
Methods: The study included 148 women aged 18–35 years: 46 healthy controls, 36 with HA, and 66 with PCOS. The PCOS group was stratified by BMI into lean (BMI <25 kg/m2; n = 35), overweight (BMI 25–29.9 kg/m2; n = 14), and obese (BMI ≥30 kg/m2; n = 24). Leptin concentrations were measured using a two-site DELPHIA immunoassay. Median (IQR) leptin levels are reported throughout. Group differences in serum leptin concentrations were assessed using the Kruskal-Wallis test, and associations with BMI and insulin were assessed using linear regression.
Results: Across the cohort, leptin concentrations increased with BMI (r = +2.99, r2 = 0.77; P < 0.0001). Compared to healthy controls [12.3 (5.63, 18.55)], leptin was significantly lower in HA [4.7 (2.80–8.50); P = 0.017] but higher in PCOS [24.1 (10.88–47.7); P = 0.003]. In women with PCOS, leptin increased across BMI subgroups (P = 0.0004). In lean women, (BMI <25 kg/m2), leptin levels discriminated lean PCOS from HA [lean PCOS: 11.7 (6.45–64.30), HA: 4.7 (2.80–8.50)] with an AUC of 0.79 (P < 0.0001). Across the full cohort, leptin predicted insulin concentrations (r= +3.62, r2=0.34; P < 0.001).
Conclusion: Leptin concentrations reflect adiposity but were disproportionately higher in PCOS than HA despite similar anthropometry, suggesting either relatively increased adipose mass or hypersecretion of leptin due to additional stimuli such as insulin, androgens, and inflammatory factors. Taken together, leptin shows discriminatory potential in lean women to distinguish PCOS from HA.
Volume 117
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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