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The ultrasound-derived fat fraction (UDFF) correlates positively with fatty liver severity, reflecting increased hepatic lipid accumulation and inflammation ( 1.3.2 Cardiovascular manifestations PCOS contributes to cardiovascular injury through chronic low-grade inflammation and sympathetic overactivation, as evidenced by elevated myocardial macrophage infiltration, accelerated atherosclerotic plaque development, and impaired post-infarction myocardial repairmechanisms that operate independently of conventional metabolic abnormalities ( 1.3.3 Pancreatic involvement PCOS may be associated with a 1.9-fold higher risk of pancreatic cancer, likely driven by metabolic disturbances beyond obesity or diabetes alone ( 1.3.4 Muscular complications Although specific studies on muscle involvement in PCOS remain limited, PCOS-related IR and chronic inflammation indirectly impair muscle metabolic function, promoting sarcopenia, intramuscular fat infiltration, and decreased muscle strength, which may in turn exacerbate systemic metabolic dysfunction ( These multi-organ interactions highlight the complexity of PCOS management and emphasize the need for interdisciplinary collaboration to optimize treatment strategies ( Figure 1 )

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