Prevalence of central obesity/increased waist to hip ratio among women with polycystic ovarian syndrome who attend gynecologycal clinics in tertiary care hospitals in Sri Lanka

Background: Polycystic ovary syndrome (PCOS) is an endocrine disorder with important reproductive and metabolic consequences, including a recognised association with central obesity. Objectives were to describe prevalence of central obesity (increased waist to hip ratio) among women with polycystic ovarian syndrome who attend to gynecological clinics in tertiary care hospitals in Sri Lanka. Methods: A descriptive cross-sectional study was conducted at the gynecology clinic of Colombo South Teaching Hospital Sri Lanka, from January to December 2025. Women diagnosed with PCOS by the modified Rotterdam criteria within the preceding three months were recruited by convenience sampling (n=165); those with other causes of hyperandrogenism, current pregnancy, or ongoing dietary or lifestyle modification were excluded. Waist and hip circumferences were measured and the waist-to-hip ratio calculated, with 0.85 taken as the cut-off for central obesity. Data were analyzed using SPSS version 28.0. Results: For waist circumference, the largest proportion measured <80 cm (n=53; 32.1%). For hip circumference, most measured 101-110 cm (n=74; 44.8%), and the commonest waist-to-hip ratio category was 0.81-0.90 (n=52; 31.5%). The mean age was 28.9 (SD= 5.6 years). Anovulation was present in 90 participants (54.5%) and hyperandrogenism in 143 (86.7%). The commonest phenotype was classic (Frank-A) PCOS (n=71). Central obesity was identified in 93 participants (56.0%; 95% CI 48.4-63.6). Anthropometric measures differed significantly across phenotypes, being highest in classic PCOS (mean waist-to-hip ratio 0.95) and lowest in the ovulatory and non-hyperandrogenic phenotypes (p<0.001). Conclusions: Central obesity was common among women with PCOS and differed significantly by phenotype, being greatest in classic PCOS. The waist-to-hip ratio may serve as a simple marker to identify women with PCOS at higher metabolic risk who warrant screening and preventive intervention.