Insulin Level Coupled with Waist Circumference for Predicting Cardiovascular Risk in Women with PCOS

Background & Objective: Polycystic Ovary Syndrome (PCOS) affects 6-22% of reproductive-aged women and often managed for immediate symptoms rather than long-term risks such as Cardiovascular Disease (CVD). As PCOS is strongly linked to adverse metabolic outcomes, early identification of markers predicting CVD risk is essential. This study was conducted with aim to evaluate the predictive value of insulin levels and waist circumference for cardiovascular risk in women with PCOS.Materials & Methods: cross-sectional study was conducted among reproductive-aged women diagnosed with PCOS at referral hospital between January and December 2024. Anthropometric measurements, gynecological examinations, and laboratory parameters (lipid profile, gonadotropins, fasting insulin, and glucose) were collected. Cardiovascular risk was assessed using the triglyceride-to-HDL cholesterol (TG/HDL-C) ratio, with cut-off >2.5. Statistical analyses were performed using SPSS version 26.Results: Total of 76 respondents were included, with median age of 28 (23-35) years, 73% were overweight or obese. In bivariate analysis, waist circumference, BMI, fasting insulin, HDL, and triglycerides were significantly associated with cardiovascular risk (P<0.05). In multivariate analysis, fasting insulin remained the only statistically significant independent predictor of cardiovascular risk (P=0.034), whereas waist circumference showed a trend toward significance but did not meet the threshold for independent association (P=0.073).Conclusion: Fasting insulin is a significant independent predictor of cardiovascular risk in women with PCOS. Although not independently significant, waist circumference remains clinically important due to its metabolic relevance. Both measures may serve as practical tools for early cardiovascular risk stratification in PCOS populations.