MON-174 - Deconstructing Triglyceride Glucose-Body Mass Index in Normal Weight Polycystic Ovary Syndrome Women and Normoandrogenic Ovulatory Controls

Objective: An elevated triglyceride glucose-body mass index as a surrogate of insulin resistance has been used in normal weight women with polycystic ovary syndrome to predict reduced pregnancy outcome by in vitro fertilization (1,2). This study examines the triglyceride glucose-body mass index in normal weight women with polycystic ovary syndrome and age-/body mass index-matched normoandrogenic ovulatory controls to identify its relevant underlying biological pathways in these female groups.

Design: Retrospective cohort study
Setting: Academic medical center.
Subjects: Twenty-one normal weight women with polycystic ovary syndrome and 19 age- and body mass index-matched controls.
Intervention(s): All women underwent fasting circulating metabolic/androgenic determinations.
Main Outcome Measure(s): The triglyceride glucose-body mass index was compared between women with polycystic ovary syndrome and age-/body mass index-matched controls and correlated with metabolic/androgenic outcomes.

Results: Serum luteinizing hormone/androgen levels and fasting serum triglyceride/insulin levels were significantly greater in women with polycystic ovary syndrome than controls (luteinizing hormone/androgen levels, P< 0.005 all values; triglyceride, P=0.028; insulin, P=0.037). Adipose insulin resistance also was increased in women with polycystic ovary syndrome compared to controls (P < 0.005). Triglyceride glucose-body mass index and homeostasis model assessment of insulin resistance tended to be higher in women with polycystic ovary syndrome than controls (triglyceride glucose-body mass index, P=0.061; homeostasis model assessment of insulin resistance, P=0.071). In multivariable linear regression, triglyceride glucose-body mass index was not associated with polycystic ovary syndrome status (P=0.69), serum free testosterone (P=0.24) or fasting serum insulin (P=0.69) levels. Instead, in all women combined, higher triglyceride glucose-body mass index levels strongly associated with greater adipose insulin resistance (P=0.01), with triglyceride glucose-body mass index levels also positively correlated with serum non-high-density lipoprotein cholesterol (P=0.02) and negatively correlated with serum high-density lipoprotein cholesterol (P=0.02) levels.

Conclusion: Adipose insulin resistance accompanying altered lipid metabolism underlies the triglyceride glucose-body mass index of normal weight women with polycystic ovary syndrome and age-/body mass index-matched controls. The trend in increased triglyceride glucose-body mass index of normal weight polycystic ovary syndrome women with low-normal insulin sensitivity, however, does not predict an increased risk of reduced pregnancy outcome by in vitro fertilization.
References
1. Wu S, et al. BMC Pregnancy Childbirth 2025;25:25.
2. Ding Z, et al. Front Endocrinol 2025;16:1629837

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