Relationship between the triglyceride/high-density lipoprotein-cholesterol ratio, insulin resistance index and cardiometabolic risk factors in women with polycystic ovary syndrome

Objective: To evaluate the relationship between the triglyceride/high density lipoprotein cholesterol (TG/HDL-c) ratio, insulin resistance index and cardiometabolic risk factors in women with polycystic ovary syndrome (PCOS).

Methods: The present crosssectional study analyzed 62 women with PCOS and 48 healthy women (control group) aged 17- 35 years old. Body mass index (BMI), waist circumference (WC) and blood pressure were registered. Plasma concentrations of glucose, insulin, triglycerides, total cholesterol and HDL-c were measured. TheTG/HDL-c ratio, homeostasis model assessment for insulin resistance (HOMA(IR)) and quantitative insulin sensitivity check index (QUICKI) were calculated.

Results: Women with PCOS showed significantly higher values of the TG/HDL-c ratio and HOMA(IR), and a significantly lower QUICKI value. These differences were related to BMI and WC, with the highest values being observed in obese patients. The 50th percentile for the TG/HDL-c ratio was 3.64; the TG/cHDL ratio was positively correlated with BMI, WC and HOMA(IR) (r=0.48, p<0.001; r=0.58, p<0.001; r=0.43, p<0.001 respectively) and was negatively correlated with the QUICKI (r=-0.51; p<0.001). Women with PCOS showed a higher frequency of fasting glucose > 100 mg/dl (10% vs 3%; p<0.05), triglycerides>150 mg/dl (55% vs 20%; p<0.05) and WC>80 cm (82.3% vs 43.8%; p<0.001). Metabolic syndrome was also more frequent in women with PCOS than in controls (31% vs 10%). The independent variable with the strongest influence on TG/HDL-c was WC (p<0.001).

Conclusions: This cross-sectional study demonstrates that women with PCOS show significantly higher values of the TG/HDL-c ratio, which is closely related to WC and insulin resistance and sensitivity indexes (HOMA(IR), QUICKI). The TG/HDL-c ratio could be considered as a useful and practical method to identify an increased risk of cardiovascular disease in patients with PCOS.