Uric Acid as a Biochemical Marker of Metabolic Dysfunction in Polycystic Ovary Syndrome: Its Association with Insulin Resistance and Adiposity

Objective: The association between polycystic ovary syndrome (PCOS), a widespread endocrine disorder in childbearing-aged women, and elevated serum uric acid levels, along with its connection to metabolic disorders, remains an ongoing area of research. This study aimed to examine the associations between serum uric acid, adiposity, body composition, and hormonal parameters in patients with PCOS, while identifying independent predictors and evaluating uric acid’s role in metabolic disorders. Method: The retrospective study included 123 women with PCOS, aged 18 to 35, diagnosed according to the Rotterdam criteria, and 41 age-and body mass index (BMI)-matched controls without PCOS or hyperandrogenism. Exclusion criteria included having chronic diseases and receiving medications that affect hormonal and metabolic parameters or uric acid. Data collected comprised menstrual histories, anthropometric measurements, hormonal, metabolic, and body composition parameters. Results: Serum uric acid was significantly greater in patients with PCOS than controls (p=0.008). While age and BMI were similar across groups, waist-to-hip ratio was greater in PCOS group (p=0.009). Fasting insulin (p=0.026) and dynamic insulin indices (p=0.001) were elevated in the PCOS group, although homeostasis model assessment of insulin resistance (HOMA-IR) was comparable (p=0.064). No major differences were observed in the body composition or metabolic parameters, including lipid profiles, visceral adiposity index, and lipid accumulation product (LAP). A multiple regression analysis demonstrated that HOMA-IR (B=0.16, p<0.001), BMI (B=0.03, p=0.017), and LAP (B=0.01, p=0.035) were independent determinants of uric acid, collectively explaining 48.4% of the variance (R²=0.484, adjusted R²=0.467). Conclusion: The study revealed a significant association between increased serum uric acid levels and metabolic problems in PCOS, particularly with insulin resistance and adiposity. Uric acid may be a potential biochemical marker for early metabolic risk assessment in PCOS.