Endocrine characteristics, body mass index and metabolic syndrome in women with polycystic ovary syndrome

Research question: The study aimed to evaluate the associations of endocrine and ultrasound characteristics with metabolic syndrome in women with polycystic ovary syndrome (PCOS), and whether these associations were modified by body mass index (BMI). Design: The study was a secondary analysis of baseline data from a randomized controlled trial of induction of ovulation in women with PCOS. Results: Among 947 Chinese women with PCOS, 153 (16.2%) were diagnosed with metabolic syndrome. The prevalence of metabolic syndrome in women with normal (<24 kg/m²) and high (≥24 kg/m²) BMI was 3.6% and 30.5%, respectively. In all women, a high free androgen index (FAI ≥5%) was positively associated with metabolic syndrome (adjusted odds ratio [OR] 2.06, 95% confidence interval [CI] 1.11–3.82). High FAI was positively associated with metabolic syndrome among women with high BMI (adjusted OR 3.37, 95% CI 1.78–6.37), but the association was not significant in women with normal BMI (adjusted OR 1.27, 95% CI 0.34–4.70). The presence of polycystic ovary morphology was negatively associated with metabolic syndrome (adjusted OR 0.52, 95% CI 0.26–1.03) in all women (normal BMI adjusted OR 0.42, 95% CI 0.11–1.67; high BMI adjusted OR 0.54, 95% CI 0.23–1.28). LH, sex hormone-binding globulin (SHBG) and anti-Müllerian hormone (AMH) were negatively associated with metabolic syndrome. The associations of FAI, SHBG and AMH in relation to metabolic syndrome were significantly modified by BMI. Conclusion(s): The associations of endocrine characteristic with metabolic syndrome were modified by BMI in women with PCOS. Women with PCOS and normal BMI did not have an increased risk of metabolic syndrome.