By Ana Espino | Published on september 18, 2025 | 3 min read
#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.
Read next: PCOS: Is homocysteine the hidden fertility marker?
About the author – Ana EspinoPhD in Immunology, specialized in Virology
