Insulin Resistance and Cardiometabolic Risk Markers in Women with PCOS at Tertiary Care Hospitals in Sindh

Objective: This study aimed to evaluate the relationship between IR, biochemical parameters, and cardiometabolic risk factors in women with PCOS at tertiary care hospitals in Sindh, Pakistan. Material and Methods: A cross-sectional study was conducted from 01 March to 31 December 2024 at Liaquat University of Medical and Health Sciences, Jamshoro. A total of 120 women aged 18–45 years with PCOS, diagnosed using the Rotterdam criteria, were included. Biochemical markers, including fasting glucose, fasting insulin, HOMA-IR, lipid profiles, and inflammatory markers (hs-CRP and IL-6), were analyzed. Pearson’s correlation was applied to determine relationships between variables. Results: The mean HOMA-IR was 6.28 (SD 2.13), with 90% of participants showing insulin resistance (HOMA-IR > 2.5). HOMA-IR demonstrated a strong positive correlation with fasting insulin (r = 0.892, p < 0.001) and a moderate positive correlation with fasting glucose (r = 0.479, p < 0.001). No significant correlations were observed between HOMA-IR and lipid profiles. Weak correlations with hs-CRP (r = 0.166, p = 0.070) and IL-6 (r = 0.054, p = 0.563) were noted. Conclusion: Insulin resistance is highly prevalent in women with PCOS and is strongly associated with hyperinsulinemia and glucose dysregulation. Routine metabolic screening and individualized interventions are critical to reduce long-term cardiometabolic risks in this population. Keywords: Polycystic Ovary syndrome, Insulin resistance, HOMA-IR, Cardiometabolic risk, Sindh, Pakistan