<b>Metabolic Profile Abnormalities in Polycystic Ovary Syndrome: A Clinical Pathology Approach</b>

Background: Polycystic ovary syndrome is a common endocrine-metabolic disorder in reproductive-aged women and is associated with insulin resistance, dyslipidemia, impaired glucose regulation, and hepatic biochemical abnormalities that may increase long-term cardiometabolic risk. Objective: This study aimed to compare fasting glucose, insulin resistance markers, lipid profile, and liver enzymes between women with polycystic ovary syndrome and age- and BMI-matched healthy controls attending tertiary-care hospitals in Sindh, Pakistan. Methods: This case-control study included 150 women aged 18–40 years, comprising 75 women diagnosed with polycystic ovary syndrome using Rotterdam criteria and 75 healthy controls matched for age and body mass index. Clinical assessment, anthropometric measurements, and fasting biochemical testing were performed. Fasting glucose, fasting insulin, HOMA-IR, total cholesterol, triglycerides, HDL-C, LDL-C, alanine aminotransferase, and aspartate aminotransferase were compared between groups using appropriate statistical tests, and correlations between HOMA-IR and metabolic parameters were assessed.  Results: Women with polycystic ovary syndrome had higher fasting glucose than controls (104.5 ± 12.3 vs 89.2 ± 8.6 mg/dL; p < 0.001), fasting insulin (18.7 ± 5.6 vs 9.5 ± 3.2 μIU/mL; p < 0.001), and HOMA-IR (4.8 ± 1.4 vs 2.1 ± 0.7; p < 0.001). They also showed higher triglycerides, LDL-C, total cholesterol, ALT, and AST, with lower HDL-C. HOMA-IR correlated positively with triglycerides (r = 0.63), LDL-C (r = 0.42), and ALT (r = 0.38), and negatively with HDL-C (r = -0.51). Conclusion: Women with polycystic ovary syndrome demonstrated a coordinated adverse metabolic profile involving insulin resistance, atherogenic dyslipidemia, and hepatic enzyme elevation despite comparable BMI. Routine metabolic profiling may support early risk identification and preventive management