METABOLIC VARIATIONS AMONG WOMEN WITH POLYCISTIC OVARY SYNDROME ACCORDING TO BODY MASS INDEX

Abstract

Introduction. There is a two-way relationship between obesity and polycystic ovary syndrome (PCOS). Although most individuals with PCOS are overweight or obese, a notable number maintain a normal body mass index (BMI). The conventional diagnostic approach to PCOS, based on phenotypic characteristics, categorises patients according to ovulatory function and androgen levels. This study aimed to compare clinical, metabolic, and endocrine parameters in lean and obese women diagnosed with PCOS. Methods. This cross-sectional study enrolled a total of 89 women, aged between 18 and 40 years, diagnosed with PCOS based on the Rotterdam criteria. Participants were stratified into groups according to their BMI. Anthropometric measurements and venous blood samples were obtained for the evaluation of glucose metabolism, lipid profile, and selected endocrine parameters. Calculated indices included BMI, waist-to-height ratio (WHR), and the homeostasis model assessment of insulin resistance (HOMA-IR). Results. Among the 89 women with PCOS included in the study, 39.3% were classified as lean, while 60.7% were categorised as obese. Regardless of phenotypic variation, obese PCOS patients exhibited significantly elevated BMI and WHR, alongside increased levels of luteinizing hormone (LH), LH/FSH ratio, and free androgen index (FAI), higher insulin concentrations, insulin resistance, and dyslipidemia. Conversely, lean women with PCOS maintained normal insulin levels, lacked clinically relevant insulin resistance, and presented with normal lipid profiles. Conclusion. The results indicated significant differences in metabolic profiles between lean and obese patients with PCOS, regardless of phenotypic classification. Metabolic abnormalities were particularly pronounced in women with increased body weight, emphasising the need for focused care and implementation of preventive measures aimed at reducing the risk of long-term health complications. These findings highlight the importance of early metabolic screening in all PCOS patients, along with a personalised approach to management based on individual characteristics.