TyG Index: a new ally against PCOS?

#PCOS #Endocrinology #Metabolism #TyGIndex   Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, affecting up to 15–20% of this population. Although it has been extensively studied, its pathophysiological mechanisms remain only partially understood, particularly regarding the metabolic disturbances associated with it. Insulin resistance, present in nearly 75% of affected women, is a central factor in PCOS and its metabolic complications (metabolic syndrome, diabetes, fatty liver disease).   The current tools used to assess this resistance, such as HOMA-IR, though widely applied, have limitations in cost, availability, or variability. The TyG index, calculated from fasting glucose and triglyceride levels, emerges as a promising alternative marker.   In this context, the present study was undertaken to systematically and quantitatively evaluate the association between the TyG index (and its derivatives) and PCOS, in order to determine its diagnostic relevance in different clinical settings and populations.     What if a simple calculation could reveal the risk?
Fifteen observational studies, totaling 7,175 women, were selected and analyzed. Most of the participants included had a diagnosis of PCOS. Major databases were systematically searched according to PRISMA guidelines. Extracted data covered different TyG indices, insulin resistance, as well as metabolic syndrome criteria.   The results show that the TyG index is significantly higher in women with PCOS compared to controls (SMD = 0.34; 95% CI: 0.14–0.54), with a particularly strong association in Chinese (SMD = 0.42) and cross-sectional studies (SMD = 0.45). The TyG-BMI index also confirmed a significant association with PCOS (SMD = 0.34), while showing good ability to predict insulin resistance, with an area under the curve (AUC) of 0.81. The TyG index alone demonstrated excellent diagnostic accuracy in identifying patients with metabolic syndrome associated with PCOS, with an AUC of 0.91. Finally, subgroup analyses demonstrated the robustness of these results, regardless of age, BMI, or lipid profile, confirming the overall value of this marker across different clinical contexts.   Towards simplified metabolic screening
PCOS is a complex endocrine–metabolic disorder, often associated with insulin resistance that is difficult to assess in routine clinical practice. This study aimed to determine the value of the TyG index as a simple, inexpensive, and reproducible marker in this context. The results demonstrate that the TyG index — and especially its derived versions such as TyG-BMI — are significantly associated with PCOS and its major metabolic complications (insulin resistance, metabolic syndrome). Their diagnostic performance is comparable to, or even greater than, that of classical tools. These indices could become frontline clinical tools for early screening and metabolic risk stratification in PCOS.   However, some limitations of this study remain, justifying the need for further research. Future investigations should include longitudinal studies with long-term follow-up, broader geographic representation, and the establishment of standardized cutoff values according to PCOS phenotypes. Special attention should also be given to assessing the TyG index across the four PCOS phenotypes, which show varying degrees of insulin resistance. Finally, combining this biomarker with other clinical, genetic, or imaging approaches could improve personalized screening and the overall management of these patients.