Hormonal and Biochemical Alterations in Polycystic Ovary Syndrome: Insights from a Comparative Analysis with Non-PCOS Women

Abstract

Background: Polycystic Ovary Syndrome (PCOS) represents one of the most prevalent endocrine disorders among women in reproductive age, characterised by a constellation of reproductive, hormonal, and metabolic abnormalities. Beyond menstrual irregularities and hyperandrogenism, women with PCOS are often at increased risk of insulin resistance, obesity, dyslipidaemia, and long-term cardiometabolic complications. A systematic comparison of these parameters with women free from PCOS is essential to delineate the disease burden and identify early intervention points.

Objective: The present work sought to undertake a detailed comparison of hormonal, biochemical, and anthropometric indices between women diagnosed with PCOS and age-matched non-PCOS counterparts.

Methods: A case–control design was adopted, enrolling 200 participants (100 PCOS cases and 100 controls) aged 18–40 years, with sample size determined through power estimation (80% power, α=0.05). Diagnosis of PCOS was based on the Rotterdam criteria. Anthropometric data included body mass index (BMI), waist–hip ratio, and blood pressure. Biochemical evaluation comprised fasting glucose, two-hour oral glucose tolerance test (OGTT), serum insulin, HOMA-IR, and a detailed lipid profile. Hormonal assessments covered luteinising hormone (LH), follicle-stimulating hormone (FSH), LH/FSH ratio, total and free testosterone, sex hormone-binding globulin (SHBG), dehydroepiandrosterone sulphate (DHEAS), prolactin, thyroid-stimulating hormone (TSH), and estradiol. Statistical testing was carried out using Student’s t-test and chi-square analysis; p values <0.05 were considered significant.

Results: PCOS subjects exhibited significantly higher BMI, waist–hip ratio, and systolic blood pressure compared with controls (p<0.01). Fasting glucose, insulin concentrations, and HOMA-IR indicated pronounced insulin resistance. Lipid profiles showed elevated triglycerides and LDL-C with concomitant reductions in HDL-C (p<0.05). Hormonal data revealed increased LH, testosterone, and DHEAS levels alongside a higher LH/FSH ratio, whereas SHBG was markedly lower. No significant differences were observed in prolactin or TSH.

Conclusion: Women with PCOS display clear metabolic and endocrine deviations from their non-PCOS peers, particularly in relation to hyperandrogenism, insulin resistance, and dyslipidaemia. These alterations highlight the importance of early recognition and integrated clinical management to reduce future risks of infertility, diabetes, and cardiovascular disease.