Prevalence and Predictors of Metabolic Syndrome in Women with Polycystic Ovarian Syndrome: A Cross-Sectional Study

Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age and is strongly associated with metabolic disturbances. The coexistence of PCOS and metabolic syndrome (MetS) significantly increases the risk of type 2 diabetes mellitus and cardiovascular disease. The present study aimed to determine the prevalence and predictors of MetS among women with PCOS attending a tertiary care hospital in South India.

A hospital-based cross-sectional study was conducted among 70 women aged 18-45 years diagnosed with PCOS as per the Rotterdam 2003 criteria. Data on demographic, clinical, anthropometric, biochemical, and lifestyle factors were collected using a structured proforma. MetS was diagnosed based on the National Cholesterol Education Program's Adult Treatment Panel III (NCEP ATP III, 2005) revised criteria with Asian-specific waist circumference cut-offs. Statistical analyses included chi-square tests, independent t-tests, and binary logistic regression to identify independent predictors of MetS.

The overall prevalence of MetS was 32 (45.7%) (95% CI: 33.9-57.8%). Among individual MetS components, 54 (77.1%) had elevated waist circumference, 46 (65.7%) had low HDL cholesterol, 38 (54.3%) had high triglycerides, 28 (40.0%) had elevated blood pressure, and 26 (37.1%) had elevated fasting glucose. Women aged ≥26 years 26(81.3%), obese with BMI ≥27.5 kg/m² 26 (81.3%), and centrally obese (waist ≥88 cm; 30(93.8%)) were significantly more likely to have MetS (p<0.001). Insulin resistance (homeostasis model assessment of insulin resistance (HOMA-IR) ≥2.5) was present in 30 (93.8%) women with MetS compared to 18 (47.4%) without MetS (p=0.013). Lifestyle factors such as low physical activity (26, 81.3%) and high refined-carbohydrate intake (28, 87.5%) were also strongly associated.

Nearly half of women with PCOS had MetS, predominantly driven by obesity, central adiposity, and insulin resistance. Routine metabolic screening, early lifestyle modification, and integrated management are essential to prevent long-term cardiometabolic complications in this high-risk group.