Comparative Analysis of Clinical and Metabolic Profiles in Insulin-Resistant and Non-Resistant Polycystic Ovary Syndrome Patients

Abstract

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women. It is often associated with insulin resistance (IR), which exacerbates reproductive and metabolic dysfunctions. Understanding the clinical and metabolic variations between insulin-resistant and non-resistant PCOS patients is vital for individualized management. This study aimed to compare the clinical and metabolic profiles of insulin-resistant and non-resistant PCOS patients to identify distinguishing features. Methods: This cross-sectional observational study was conducted at the Department of Obstetrics and Gynaecology, Dhaka Medical College Hospital from June 2022 to May 2023, involving 75 PCOS-diagnosed women aged 18–40. Based on HOMA-IR scores, patients were grouped into insulin-resistant (HOMA-IR >1.9; n=45) and insulin non-resistant (HOMA-IR ≤1.9; n=30) groups. Clinical characteristics, anthropometric data, and biochemical parameters were compared. Statistical analysis was performed using SPSS v23.0. Results: Insulin-resistant patients showed higher prevalence of hirsutism (82.2% vs. 66.7%) and acne (73.3% vs. 56.7%), though not statistically significant. Oligomenorrhea was more frequent in the IR group (86.7% vs. 66.7%). Mean BMI, WHR, and blood pressure values were similar across groups. Notably, elevated TSH levels (>2.5 mIU/L) were significantly more common in the IR group (68.9% vs. 23.3%; p=0.001). Conclusion: Insulin resistance in PCOS is associated with more adverse clinical and metabolic features, particularly elevated TSH levels. Routine assessment of insulin resistance and thyroid function in PCOS patients is essential for early risk stratification and management.