Metabolic syndrome prevalence clinical profile and associated metabolic risk factors among women with polycystic ovary syndrome in a tertiary care setting

Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder affecting women of reproductive age and is associated with insulin resistance, dyslipidemia, obesity, and an increased risk of metabolic syndrome (MetS). Early identification of metabolic abnormalities is essential to reduce future cardiometabolic complications. This study aimed to determine the prevalence of metabolic syndrome, describe its clinical and metabolic profile, and evaluate its association with age and body mass index (BMI) among women with PCOS attending a tertiary care hospital. A hospital-based descriptive cross-sectional study was conducted among 480 women aged 15–40 years diagnosed with PCOS according to the Rotterdam criteria. Participants were recruited from the gynecology outpatient department using convenience sampling during the study period. Clinical assessment included anthropometric measurements and blood pressure, while biochemical evaluation included fasting blood glucose, triglycerides, and high-density lipoprotein (HDL) cholesterol. MetS was defined according to modified National Cholesterol Education Program Adult Treatment Panel III criteria, incorporating the South Asian-specific waist circumference threshold of ≥ 80 cm. Associations were assessed using chi-square tests and independent t -tests. Prevalence was reported with 95% confidence intervals (CIs). Among the 480 women with PCOS, 210 had MetS, corresponding to a prevalence of 43.8% (95% CI: 39.4–48.3%). Low HDL cholesterol (81.3%), central obesity (58.3%), and hypertriglyceridemia (41.7%) were the most prevalent metabolic abnormalities. The prevalence of MetS increased significantly across age groups ( p < 0.001) and BMI categories ( p < 0.001), with the highest prevalence observed among women aged 30–34 years (58.8%) and those with obesity (84.6%). Women with MetS had significantly higher mean BMI, waist circumference, fasting blood glucose, triglyceride levels, and blood pressure and lower HDL cholesterol levels than those without MetS (all p < 0.001). MetS was highly prevalent among women with PCOS in this tertiary care population, with low HDL cholesterol, central obesity, and hypertriglyceridemia representing the predominant metabolic abnormalities. MetS was significantly associated with increasing age and BMI. These findings support routine metabolic screening and early lifestyle-based interventions in women with PCOS. However, because of the cross-sectional design, single-center setting, and convenience sampling, the observed associations should be interpreted as associations rather than evidence of independent predictors or causal relationships. The findings may not be directly generalizable to women with PCOS in community or other healthcare settings. Prospective multicenter studies are warranted to identify independent determinants of MetS and establish temporal relationships.