Triglyceride/High-density Lipoprotein Cholesterol Ratio and Triglyceride–Glucose Index: Potential Cost-effective Markers of Insulin Resistance in Polycystic Ovary Syndrome

A BSTRACT Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder marked by insulin resistance (IR). IR is a critical factor not only in diabetes but also in other conditions like dyslipidemia and metabolic syndrome, which increase the risk of cardiovascular events in PCOS patients. The triglyceride/high-density lipoprotein (TG/HDL) ratio as well as triglyceride–glucose (TyG) index has emerged as a promising marker of IR. Our study investigated the utility of the TG/HDL ratio and TyG index to assess IR levels in women with PCOS. Methods: A total of 160 patients diagnosed with PCOS according to the Rotterdam criteria and 55 healthy subjects participated in this cross-sectional study. Anthropometric measurements, fasting glucose levels, fasting insulin levels, and lipid profiles were measured in all participants. TG/HDL ratio, TyG index, homeostasis model assessment for IR (HOMA-IR), and quantitative insulin sensitivity check index (QUICKI) were then calculated. Results: PCOS women had a significantly higher body mass index and waist–hip ratio with increased fasting glucose, total cholesterol (TC), and low-density lipoprotein compared to the control group. There was no significant difference in HOMA-IR, Quantitative insulin sensitivity check index (QUICKY), TG-HDL ratio, TC-HDL ratio, and plasma glucose level among the groups. However, obese PCOS patients exhibited significantly higher HOMA-IR, fasting insulin, and lower fasting glucose–insulin ratio and QUICKI compared to nonobese PCOS patients. Elevated TG/HDL ratio and TyG index demonstrated significant positive correlations with HOMA-IR and negative correlations with QUICKI, suggesting their potential as markers of IR in this PCOS population. Conclusion: Our findings suggest that elevated TG/HDL ratio and TyG index are significantly associated with IR in women with PCOS.