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Objective: To assess the rate of insulin resistance (IR) and the relationship between IR and high molecular weight (HMW) adiponectin in normal weight adolescents with polycystic ovary syndrome (PCOS) and a maternal history of PCOS., Design: Case-controlled study., Setting: Adolescent clinic of a teaching and research hospital., Patient(s): Forty normal weight adolescents with PCOS and a maternal history of PCOS and 40 normo-ovulatory age- and body mass index (BMI)-matched controls., Intervention(s): A 75-g oral glucose tolerance test (OGTT) was performed for each participant., Main Outcome Measure(s): Homeostasis model assessment of IR and HMW adiponectin., Result(s): There were no statistically significant differences between the PCOS and control groups in terms of fasting glucose, fasting insulin, and lipid parameters. Although total and free T were significantly higher, HMW adiponectin levels were significantly lower in the PCOS group compared with the control group. When the PCOS group was compared according to the IR, the HMW adiponectin level was significantly lower in the adolescents with PCOS and IR. The adolescents with PCOS and biochemical hyperandrogenemia had significantly lower HMW adiponectin levels and significantly higher homeostasis model assessment of IR score compared with the adolescents with PCOS and normoandrogenemia., Conclusion(s): The adolescents with PCOS had a significantly increased rate of IR without clinical findings of metabolic disorders or obesity. The HMW adiponectin levels were negatively correlated with IR., (Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)