Prevalence and predictors of metabolic syndrome in women with polycystic ovarian syndrome: a study from Southern India

Jisha Varghese, Supriya Kantharaju, Suchitra Thunga, Nitin Joseph, Prakhar Kumar Singh


Background: Metabolic syndrome (MBS) is a common disorder and is thought to be highly prevalent in polycystic ovarian syndrome (PCOS). The objectives were to find out the prevalence and predictors of metabolic syndrome in women with PCOS.

Methods: Forty five women diagnosed with PCOS, underwent clinical and laboratory assessments for the diagnosis of metabolic syndrome, as per modified National Cholesterol Education Program’s Adult Treatment Panel III (NCEP ATP III criteria).

Results: Twenty four (53.3%) subjects had metabolic syndrome. The prevalence of individual components of the metabolic syndrome among PCOS patients were: waist circumference ≥80 cm in 36 (86.6%), High Density Lipoprotein (HDL-C) less than 50 mg/dl in 42 (93.3%), triglycerides ≥150 mg/dl in 17 (37.8%), blood pressure ≥130/85 mmHg in 7 (15.6%), and fasting plasma glucose ≥100 mg/dl in 13 (28.8%). Subjects with MBS had significantly higher BMI compared to those without (P = 0.039). However, fasting insulin and free testosterone levels did not differ significantly between subjects with and without MBS.

Conclusions: The metabolic syndrome and its individual components, waist circumference ≥80 cm in particular were found to be common among PCOS patients in this study. This along with high BMI being significantly associated with MBS suggests immediate need of interventions like lifestyle changes for prevention of MBS and other cardiovascular diseases. Also, as dyslipidemia was more common than impaired fasting glucose among PCOS patients, finding of one risk factor should prompt the clinician to search for other risk factors.


Polycystic ovarian syndrome, Metabolic syndrome, Ethnic specific BMI, Modified NCEP ATP III criteria

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Azziz R, Woods KS, Reyna R, Key TJ, Knochenhauer ES, Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metabol. 2004;89(6):2745-9.

Probstfield JL, Byington RP, Egan DA, Espeland MA, Margitic SE, Riley WA Jr, et al. Methodological issues facing studies of atherosclerotic changes. Circulation. 1993;87:1174-81.

DeFronzo RA, Ferrannini E. Insulin resistance. A multifaceted syndrome responsible for NIDDM, obesity, hypertension, dyslipidemia and atherosclerotic cardiovascular disease. Diabetes Care. 1991;14:173-94.

Grundy SM, Cleeman JL, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung and Blood Institute Scientific Statement. Circulation. 2005;112:2735-52.

Third report of the National Cholesterol Education Program (NCEP). Expert panel on detection, evaluation and treatment in high blood cholesterol in adults (Adult Treatment Panel 111) final report. Circulation. 2002;106(25):3143-421.

Vrbikova J, Vondra K, Cibula D, Dvoráková K, Stanická S, Srámková D, et al. Metabolic syndrome in young Czech women with polycystic ovary syndrome. Hum Reprod. 2005;20:3328-32.

Dokras A, Bochner M, Hollinrake E, Markham S, Vanvoorhis B, Jagasia DH. Screening women with polycystic ovary syndrome for metabolic syndrome. Obstet Gynecol. 2005;106:131-7.

The Rotterdam ESHRE/ASRM, Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19-25.

World Health Organization. International association for the study of international obesity task force. The Asia-Pacific perspective redefining obesity and its treatment, 2000. Available at:

Dey R, Mukherjee S, Roybiswas R, Mukhopadhyay A, Biswas SC. Association of metabolic syndrome in polycystic ovarian syndrome: an observational study. J Clin Obstet Gynecol India. 2011 Mar/Apr;61(2):176-81.

Bhattacharya SM. Metabolic syndrome in females with polycystic ovary syndrome and International Diabetes Federation Criteria. J Obstet Gynecol. 2008;34:62-6.

Mandrelle K, Mohan SK, Bondu DJ, Chandy A, Aleyamma T, George K. Prevalence of metabolic syndrome in women with polycystic ovary syndrome attending an infertility clinic at a tertiary care hospital in south India. J Hum Reprod Sci. 2012 Jan-Apr;5(1):26-31.

Apridonidze T, Essah PA, Iuorno MJ, Nestler JE. Prevalence and characteristics of the metabolic syndrome in women with polycystic ovarian syndrome. J Clin Endocrinol Metabol. 2005;90:1929-35.

Mckeigue PM, Shah B, Marmott MG. Relationship of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet. 1991;337:382-6.

SnehalathaC, Vishwanathan V, Ramachandran A. Cutoff values for normal anthropometric variables in Asian Indian adults. Diabetes Care. 2003;26:1380-4.

Vural B, Caliskan E, Turkoz E, Kilic T, Demirei A. Evaluation of metabolic syndrome frequency and premature carotid atherosclerosis in young women with polycystic ovary syndrome. Hum Reprod. 2005;9:2409-13.

Carmina E, Napoli N, Longo RA, Rini GB, Lobo RA. Metabolic syndrome in polycystic ovary syndrome: lower prevalence in southern Italy than in the USA and the influence of criteria for the diagnosis of PCOS. Eur J Endocrinol. 2006;154:141-5.

Glueck CJ, Papanna R, Wang P, Goldenberg N, Sieve-Smith L. Incidence and treatment of metabolic syndrome in newly referred women with confirmed polycystic ovarian syndrome. Metabolism. 2003;52:908-15.

Ehrmann DA, Liljenquist DR, Kasza K, Azziz R, Legro RS, Ghazzi MN, et al. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metabol. 2006;91(1):48-53.

Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev. 1997;18:774-800.

Dunaif A, Segal KR, Futterweit W, Dobrjansky A. Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989;38: 1165-74.

Ehrmann DA, Barnes RB, Rosenfield RL, Cavaghan MK, Imperial J. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999;22:141-6.

Janus ED, Watt NM, Lam KS, Cockram CS, Siu ST, Liu LJ, et al. The Prevalence of diabetes, association with cardiovascular risk factors and implications of diagnostic criteria (ADA 1997 and WHO 1998) in a 1996 community-based population study in Hong Kong Chinese. Hong Kong Cardiovascular Risk Factor Steering Committee. American Diabetes Association. Diabet Med. 2000;17:741-5.