Targeted metabolomics and fatty acid profiling in lean and obese polycystic ovarian syndrome patients: A pilot study

Introduction: Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting approximately 10 % of women globally, with variations in prevalence across geographic regions. It is strongly associated with metabolic disturbances causing dyslipidaemia, increased risk for diabetes and cardiovascular diseases. This study investigates the metabolic implications of body mass index (BMI) in PCOS, focusing on targeted metabolomics and fatty acid profiling. Methodology: 23 PCOS patients and 12 normal healthy female participants in the age group 17-35 years were recruited. PCOS was diagnosed based on revised Rotterdam criteria and classified into respective phenotypes. PCOS patients were further categorized into lean (n = 15) and obese (n = 8) groups based on BMI. Absolute quantification of fatty acids was done by Gas Chromatography (GC)-mass spectrometry (MS). ANOVA was used to compare between the PCOS subgroups. Metabolic enrichment pathway analysis was used for the identified fatty acids. Results: Significantly different fatty acid profiles were observed between the PCOS and control groups. Elevated level of hexadecenoic acid (8.819 ± 2.63 µg/mL) was found in PCOS subjects compared to controls. Cis-10-heptadecenoic acid levels were highest in control (59.8 ± 3.17 µg/mL) and lean PCOS (59.0 ± 3.35 µg/mL) subjects. The phenotype B demonstrated significantly higher levels of 9-hexadecenoic acid (13.576 ± 0.132 µg/mL) than other phenotypes. Functional enrichment analysis and Variable Importance in Projection (VIP) score calculation revealed dysregulated very long-chain fatty acid oxidation, fatty acid biosynthesis, and arachidonic acid metabolism in PCOS. Conclusion: Fatty acid profiling and metabolic analysis showed dysregulation between PCOS subjects based on BMI. The lean PCOS could be more involved with hormonal regulation than the adipocyte dysfunction.