Atherogenic Burden and Insulin Resistance in Non-Obese Women with Polycystic Ovary Syndrome: A Comparative Study with Healthy Controls

Burak Andaç; Mehtap Navdar Başaran; Gözde Nur Eren

doi:10.18621/eurj.1815977

Atherogenic Burden and Insulin Resistance in Non-Obese Women with Polycystic Ovary Syndrome: A Comparative Study with Healthy Controls

Abstract

Objectives: Polycystic ovary syndrome (PCOS) is associated with elevated cardiovascular disease (CVD) risk due to metabolic derangements. Although obesity contributes to CVD, the independent contribution of PCOS remains controversial. This study aimed to compare insulin resistance (IR) and atherogenic lipid indices across body mass index (BMI) categories within PCOS, to evaluate the diagnostic performance of atherogenic indices between non-obese PCOS and healthy controls, and to derive exploratory, data-driven thresholds that may inform cardiovascular risk assessment in non-obese PCOS.

Methods: This single-center case-control study enrolled 65 treatment-naïve women newly diagnosed with PCOS (Rotterdam criteria 2003) and 100 age-matched healthy controls. A panel of IR and composite atherogenic lipid indices (e.g., Lipid Accumulation Product [LAP], Visceral Adiposity Index [VAI], Triglyceride-Glucose [TyG] Index) was compared between groups.

Results: Within PCOS, atherogenic lipid indices were similar in obese versus non-obese subgroups. Non-obese PCOS demonstrated significantly higher atherogenic lipid and IR indices compared to controls (all P<0.05). Receiver operating characteristic (ROC) curve analysis identified LAP (Area under the curve [AUC] =0.747, 95% confidence intervals [CI]: 0.647-0.844, threshold=18.05), VAI (AUC=0.707, 95% CI: 0.605-0.811, threshold=1.15), and TyG (AUC=0.701, 95% CI: 0.583-0.814, threshold=8.29) as the three best indices distinguishing non-obese PCOS from healthy controls.

Conclusions: Elevated atherogenic lipid and IR indices in non-obese PCOS compared to non-obese controls, alongside similar atherogenic markers between obese and non-obese PCOS groups are consistent with the notion that PCOS may independently contribute to atherogenesis beyond obesity-related mechanisms. In this exploratory analysis, data-driven thresholds for LAP, VAI and TyG were identified in non-obese PCOS. These values require external validation in larger, multi-center cohorts before they can be considered for routine CVD risk screening or monitoring.

Keywords

Ethical Statement

This study was approved by the Ordu University Faculty of Medicine Ethics Committee (Decision No: BAEK 2025/341; date: 17.10.2025). All procedures were conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments. Because the study was retrospective and no additional intervention was performed on the participants, the informed consent form was waived.

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Details

Primary Language

English

Subjects

Endocrinology

Journal Section

Research Article

Authors

Burak Andaç ^*
0000-0001-8680-0313
Türkiye

Mehtap Navdar Başaran
0000-0001-7817-2871
Türkiye

Gözde Nur Eren This is me
0009-0003-9830-7413
Türkiye

Early Pub Date

December 29, 2025

Publication Date

December 29, 2025

Submission Date

November 5, 2025

Acceptance Date

December 7, 2025

Published in Issue

Year 1970 Number: Advanced Online Publication

DOI

https://doi.org/10.18621/eurj.1815977

IZ

https://izlik.org/JA39BM73UD

Cite

RIS / Bibtex

AMA

1.Andaç B, Navdar Başaran M, Eren GN. Atherogenic Burden and Insulin Resistance in Non-Obese Women with Polycystic Ovary Syndrome: A Comparative Study with Healthy Controls. Eur Res J. 2025;(Advanced Online Publication):1-13. doi:10.18621/eurj.1815977