Figure 1.

Opposing effects of randomised interventions on the MAFLD triad of hepatic fat, HOMA-IR and circulating CRP in adolescent girls with polycystic ovary syndrome (PCOS). Adolescents with PCOS (mean age 16 years) were randomised to receive an oestro-progestagen contraceptive (OC; red) or a low-dose combination of spironolactone-pioglitazone-metformin (SPIOMET; blue). On-treatment (0–12 months) results are shown as mean and SEM; n=31 in each treatment group. The dotted line in the hepatic-fat panel refers to the average fraction in healthy controls.⁶ The dotted lines in the HOMA-IR and CRP panels refer to the cut-off levels for these MAFLD criteria.² Original data are from reference ⁶. CRP, C reactive protein; MAFLD, metabolic dysfunction-associated fatty liver disease.