Hormonal Profile and Anthropometric Indices As Determinants of Metabolic Risk in Polycystic Ovary Syndrome: A Prospective Observational Study

Napolean N; Chaurasiya S; Khanna S; Sachan S; Ritesh Singh; Dey J

doi:10.7759/cureus.105995

Reproductive Endocrinology · Ovarian Hormones

Hormonal Profile and Anthropometric Indices As Determinants of Metabolic Risk in Polycystic Ovary Syndrome: A Prospective Observational Study

Napolean N, Chaurasiya S, Khanna S, Sachan S, Singh R, Dey J

Published March 2026 Cureus, 18(3), e105995

DOI 10.7759/cureus.105995 PMID 42046610 PMC PMC13110852

RRM Academy Synopsis

Women with PCOS had higher BMI and waist ratios than controls

A cross-sectional study of 102 women aged 18 to 30 in India found that women with PCOS had higher BMI and larger waist measures than controls. PCOS is now also called polyendocrine metabolic ovarian syndrome (PMOS). Women with PCOS also had a lower finger-length ratio, a proposed sign of prenatal androgen exposure.

Key Findings

The study included 53 women with PCOS and 49 healthy controls, all recruited from one hospital outpatient department in Varanasi, India.
Menstrual irregularity appeared in all 53 women with PCOS and in none of the controls. LH, FSH and AMH were also higher in the PCOS group (all p < 0.001).
Hirsutism affected 43.4% of women with PCOS and 6.1% of controls (p < 0.001). Acne affected 49.1% and 20.4% (p = 0.002).
BMI averaged 23.36 ± 4.80 kg/m² with PCOS and 20.73 ± 2.73 kg/m² in controls (p = 0.001). Waist-hip ratio (p = 0.005) and waist-height ratio (p < 0.001) were also higher.
The second-to-fourth digit (2D:4D) ratio was lower with PCOS (p = 0.001) and correlated negatively with BMI (r = -0.724, p < 0.001). Fasting glucose did not differ (p = 0.536).

Interpretation

The study is cross-sectional: researchers measured each woman once. The results show group differences and cannot show what caused them. The authors call the sample relatively small and single-center, and the women were aged 18 to 30. Women were diagnosed with PCOS partly by irregular cycles and ultrasound findings. Controls were chosen for regular cycles and no polycystic ovarian morphology, the same features used to diagnose PCOS. The authors read the lower 2D:4D ratio as support for prenatal androgen exposure. The study did not measure that exposure directly.

RRM Context

Restorative reproductive medicine treats irregular cycles as a signal to investigate. In PCOS, hormone, cycle, and metabolic findings show up together in the same women. The study took body measures and hormone markers at one point in time. The paper reports no data on ovulation, fertility, or treatment outcomes.

Our editorial summary of this paper, not the article's abstract.

Abstract

Background

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine-metabolic disorder characterized by reproductive, hormonal, and metabolic disturbances. This study aimed to evaluate the association between clinical features, anthropometric indices, hormonal parameters, metabolic profile, ultrasonographic findings, and the second-to-fourth digit (2D:4D) ratio in women with PCOS compared to age-matched healthy controls.

Methods

A case-control study was conducted, including women diagnosed with PCOS and age-matched healthy controls. Clinical features, anthropometric measurements (BMI, waist-hip ratio (WHR), waist-height ratio (WHtR)), hormonal parameters (luteinizing hormone (LH), follicle-stimulating hormone (FSH), anti-Müllerian hormone (AMH)), metabolic variables (fasting glucose, lipid profile), ultrasonographic findings, and 2D:4D digit ratio were assessed. Statistical analysis was performed using appropriate tests, and a p-value < 0.05 was considered statistically significant.

Results

Women with PCOS exhibited a significantly higher prevalence of menstrual irregularity, polycystic ovarian morphology, hirsutism, and acne (p < 0.001). Hormonal analysis showed significantly elevated LH, FSH, and AMH levels in PCOS cases (p < 0.001). Anthropometric indices, including BMI, WHR, and WHtR, were significantly higher among PCOS cases (p < 0.01), indicating increased general and central adiposity. In contrast, fasting glucose and lipid profile levels did not differ significantly between groups. Additionally, the 2D:4D ratio was significantly lower in PCOS cases (p < 0.01) and showed significant negative correlations with BMI, WHR, WHtR, and cholesterol levels.

Conclusion

The study demonstrates that PCOS is associated with significant hormonal dysregulation, central obesity, and early metabolic alterations. The lower 2D:4D ratio observed in PCOS supports the role of prenatal androgen exposure in disease pathogenesis. These findings highlight the complex interplay between developmental, metabolic, and endocrine factors in PCOS and underscore the importance of early identification and comprehensive management strategies.

Topics

Reproductive Endocrinology › Ovarian Hormones › Androgens · Diagnostics › Hormone Testing › Serum Panels · Menstrual Cycle › Cycle Disorders › Ovulatory Disturbances

Ritesh Singh

R Singh

PMID 42046610 42046610 DOI 10.7759/cureus.105995 10.7759/cureus.105995 Napolean et al. 2026, Napolean 2026

Keywords

anthropometric indices, hormonal imbalance, insulin resistance, metabolic dysfunction, polycystic ovary syndrome

Hormonal Profile and Anthropometric Indices As Determinants of Metabolic Risk in Polycystic Ovary Syndrome: A Prospective Observational Study

Women with PCOS had higher BMI and waist ratios than controls

Key Findings

Interpretation

RRM Context

Abstract

Topics

By this author

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Keywords