Therapeutic Advances in Endocrinology and Metabolism (Mar 2025)

Triglyceride–glucose index and lipid ratios in women with and without polycystic ovary syndrome: a systematic review and meta-analysis

  • Juan R. Ulloque-Badaracco,
  • Esteban A. Alarcon-Braga,
  • Enrique A. Hernandez-Bustamante,
  • Juan C. Cabrera-Guzmán,
  • Giuseppe Dotto-Vasquez,
  • Gian F. Maldonado-Basurto,
  • Germán Rivera-Cabrera,
  • Sherelym H. Maita-Arauco,
  • Andres A. Horruitiner-Mendoza,
  • Percy Herrera-Añazco,
  • Vicente A. Benites-Zapata,
  • Faustino R. Pérez-López

DOI
https://doi.org/10.1177/20420188251328840
Journal volume & issue
Vol. 16

Abstract

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Background: The pathophysiology of polycystic ovary syndrome (PCOS) is complex and heterogeneous. This systematic review and meta-analysis aimed to determine the triglyceride–glucose index and lipid ratios in women with and without PCOS. Methods: Literature searches were performed in PubMed, Scopus, Web of Science, Scielo, and Embase for studies reporting the triglyceride–glucose index and total cholesterol/high-density lipoprotein (HDL)-cholesterol, triglyceride/HDL-cholesterol, and low-density lipoprotein (LDL)-cholesterol/HDL-cholesterol ratios. Results are reported as standardized mean differences (SMDs) along with their 95% confidence intervals (CIs). Results: The search identified 61 observational studies, including case–control ( n = 37), cohort ( n = 2), and cross-sectional ( n = 22) studies reporting results of interest according to different PCOS diagnosis criteria. Compared with the control group, the PCOS group presented increased circulating triglyceride–glucose index ( n = 9 studies, SMD, 0.41; 95% CI, 0.08–0.74) and total cholesterol/HDL-cholesterol ( n = 35 studies, SMD, 1.70; 95% CI, 0.69–2.70), triglyceride/HDL-cholesterol ( n = 31 studies; SMD, 0.81; 95% CI, 0.43–1.19), and LDL-cholesterol/HDL-cholesterol ( n = 25 studies, SMD, 2.40; 95% CI, 0.45–4.35) ratios. Statistical heterogeneity values were very high ( I 2 > 90%). The PCOS group displayed significantly higher body mass index and homeostatic model assessment of insulin resistance. The PCOS group was younger than the control group and had a higher total cholesterol/HDL-cholesterol ratio, and other lipid variables were comparable in all groups. Conclusion: Patients with PCOS show significantly higher triglyceride–glucose index and total cholesterol/HDL-cholesterol, triglyceride/HDL-cholesterol, and LDL-cholesterol/HDL-cholesterol ratios than those without the syndrome.