Endocrine Abstracts

JOINT2859

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting up to 20% of women of reproductive age. Characterized by ovarian dysfunction, hormonal imbalances, and metabolic abnormalities, PCOS has traditionally been associated with obesity. However, increasing numbers of lean women are being diagnosed with PCOS. While obesity exacerbates metabolic disturbances, non-obese PCOS women may also present significant metabolic issues. This study compares the metabolic profiles of lean and obese women with PCOS.

Subjects and Methods: This analytical cross-sectional study included 122 women diagnosed with PCOS at the Endocrinology and Diabetology Department of FARHAT HACHED Hospital in Sousse between January and December 2024. Participants were divided into two groups based on BMI: Obese PCOS (O-PCOS; BMI >25 kg/m²) and Lean PCOS (L-PCOS; BMI <25 kg/m²). Metabolic parameters assessed included anthropometric data, markers of insulin resistance, and glycemic and lipid profiles.

Results: Of the 122 participants, 38 (31.1%) were lean and 84 (68.9%) were obese. The average age was 23.61 ± 4.97 years. The mean BMI was 32.26 ± 5.85 kg/m² for O-PCOS and 21.85 ± 1.98 kg/m² for L-PCOS ( P < 0.001). Android fat distribution was significantly more prevalent in the obese group (72.6% vs. 13.2%; P < 0.001), with mean waist circumferences of 90.56 ± 10.22 cm in O-PCOS and 75.66 ± 4.59 cm in L-PCOS. Acanthosis Nigricans was significantly more common in O-PCOS (76.2%; P < 0.001). In terms of the lipid profile, hypertriglyceridemia was observed in 14.3% of obese and 13.2% of lean women ( P = 0.028), and hypercholesterolemia was present in 7.1% of the obese and 5.7% of the lean participants (P = 1.000). Additionally, the metabolic syndrome was more prevalent in O-PCOS (44% vs. 2.6%; P < 0.001). Lastly, impaired fasting glucose was noted in 19% of obese and 5.3% of lean women (P = 0.055), and impaired glucose tolerance was detected exclusively in obese participants (22.6%; P = 0.001).

Conclusion: Obese women with PCOS exhibited more pronounced metabolic abnormalities, including higher rates of metabolic syndrome, insulin resistance, and glucose intolerance. However, lean women also displayed notable metabolic disturbances. These findings underscore the importance of comprehensive metabolic assessment and individualized management strategies in all PCOS patients, regardless of BMI.