Clinical Obesity and Insulin Resistance Assessed Based on SHBG Levels and HOMA-IR, TyG-Waist Circumference (TyG-WC), TyG-Waist to Height Ratio (TyG-WHtR), and TyG-Waist to Hip Ratio (TyG-WHR) Values in Young Caucasian Women with Polyendocrine Metabolic Ovarian Syndrome (PMOS)

Objectives: The study aimed to assess (1) the prevalence of clinical obesity in a cohort of young Caucasian women with polyendocrine metabolic ovarian syndrome (PMOS), (2) estimate the cut-off value for triglyceride-glucose index—waist-to-height ratio (TyG-WHtR) and TyG—waist-to-hip ratio (TyG-WHR) indices discriminating the insulin resistance (IR) based on the HOMA-IR values and sex-hormone-binding-globulin (SHBG) levels, as well as (3) the occurrence of IR based on SHBG levels and HOMA-IR, TyG, TyG—body mass index (TyG-BMI), TyG—waist circumference (TyG-WC), TyG-WHtR, and TyG-WHR indices. Methods: This analysis included data retrieved from the medical records of 580 consecutive Caucasian women, for the first time, diagnosed with PMOS at the Gynecological Endocrinology Clinic, including anthropometric data, fasting glucose, insulin, and SHBG levels. Obesity and clinical obesity were diagnosed based on the WHO and LDEC criteria, respectively. The cut-off value for TyG-WHtR and TyG-WHR indices was calculated using receiver operating characteristic curve analysis. The occurrence of IR based on seven indices was assessed. Results: The prevalence of clinical obesity was 9.8% among women with BMI < 25 kg/m2, 70.2% with BMI 25–29.9 kg/m2, 100% with BMI > 30 kg/m2. The empirical optimal cut-off values for the TyG-WHtR, corresponding to HOMA-IR ≥ 2.1 and SHBG ≤ 43.1 nmol/L, were 4.44 and 4.35, respectively, while for the TyG-WHR, 6.94 and 6.90, respectively. None of the IR indices identified all clinically obese women. SHBG cut-off was the marker that most frequently detected IR in both subgroups with and without clinical obesity. Conclusions: 1. The application of a new definition of clinical obesity increases the classification of obesity among women with PMOS. However, further studies are necessary to confirm the cut-off points for indirect anthropometric parameters of excess visceral fat based on DXA. 2. The cut-offs for the TyG-WHtR and TyG-WHR indices discriminating IR in young Caucasian women with PMOS were similar regardless of whether they were based on HOMA-IR and SHBG cut-offs. 3. SHBG concentration can be considered the most valuable marker for the diagnosis of IR in women with PMOS, both with and without clinical obesity.