Correlation between polycystic ovarian morphology and metabolic syndrome parameters in reproductive-age women

Background: Polycystic ovarian morphology (PCOM) is a hallmark ultrasonographic feature identified in a substantial proportion of reproductive-age women, often in the context of polycystic ovary syndrome (PCOS). The relationship between PCOM and metabolic syndrome (MetS) parameters—including central adiposity, dyslipidemia, hyperglycemia, and insulin resistance—remains inadequately characterized, particularly when assessed independently of other PCOS diagnostic criteria. Methods: This cross-sectional analytical study was conducted at a tertiary care gynecology center. A total of 240 reproductive-age women (18-40 years) were enrolled and classified into two groups: PCOM group (n = 120) and normal ovarian morphology (NOM) group (n = 120), based on transvaginal ultrasonography. Metabolic parameters—fasting blood glucose (FBG), fasting insulin, homeostatic model assessment of insulin resistance (HOMA-IR), triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), waist circumference (WC), and blood pressure—were assessed. Pearson correlation coefficients and multivariate logistic regression were employed. Results: Women with PCOM exhibited significantly higher mean WC (89.74 ± 10.32 vs. 79.56 ± 8.67 cm; p < 0.001), FBG (101.28 ± 12.45 vs. 89.34 ± 9.12 mg/dL; p < 0.001), fasting insulin (16.83 ± 5.74 vs. 9.47 ± 3.28 ?U/mL; p < 0.001), HOMA-IR (4.24 ± 1.82 vs. 2.11 ± 0.89; p < 0.001), TG (158.62 ± 38.41 vs. 118.27 ± 29.56 mg/dL; p < 0.001), and lower HDL-C (41.53 ± 6.87 vs. 52.18 ± 8.24 mg/dL; p < 0.001). MetS prevalence was significantly higher in the PCOM group (38.3% vs. 11.7%; p < 0.001). Ovarian volume was positively correlated with HOMA-IR (r = 0.52; p < 0.001) and TG (r = 0.41; p < 0.001). Conclusion: PCOM is significantly associated with adverse metabolic syndrome parameters, particularly insulin resistance and atherogenic dyslipidemia. Systematic metabolic screening of women with PCOM is warranted irrespective of the full PCOS diagnosis.