Assessing the Discriminative Power of Metabolic Indices for PMOS Detection in Normal-Weight Women

This study aimed to investigate the relationship between metabolic indices and Polyendocrine Metabolic Ovarian Syndrome (PMOS) in normal-weight women and to evaluate their individual and combined discriminatory performance.

This retrospective case-control study included 86 normal-weight women (BMI <25 kg/m²) with PMOS and 88 healthy controls. Electronic medical records were used to calculate the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), Triglyceride-Glucose (TyG) index, Atherogenic Index of Plasma (AIP), and Metabolic Score for Insulin Resistance (METS-IR). Receiver operating characteristic (ROC) curve analysis was used to assess discriminatory performance, and optimal cut-off values were determined using the Youden index. Combined analyses were performed according to concordant classification of the component indices relative to their respective cut-off values.

Fasting glucose, fasting insulin, triglyceride levels, HOMA-IR, TyG, AIP, and METS-IR were significantly higher in women with PMOS (p<0.05). Among individual indices, TyG showed the highest discriminatory performance (AUC=0.775; 95% CI: 0.706-0.843). HOMA-IR and AIP demonstrated moderate discriminatory performance, whereas METS-IR showed lower performance. Among the combined assessments, HOMA-IR and TyG yielded an AUC of 0.830 (95% CI: 0.747-0.913), with 80.8% sensitivity and 85.2% specificity.

Metabolic indices, particularly TyG, may be useful for identifying metabolic abnormalities in normal-weight women with PMOS. Combined assessment of complementary metabolic indices may provide additional information for metabolic risk evaluation. These findings support further investigation of such indices as practical tools for metabolic assessment and risk stratification, rather than as independent diagnostic criteria for PMOS.