correlation of serum lipoprotein ratios with insulin resistance in infertile women with polycystic ovarian syndrome: a case control study

objective: dyslipidemia and insulin resistance (ir), occurring in most infertile women with polycystic ovarian syndrome (pcos), increase the risk of cardiovascular disease (cvd) and type 2 diabetes. this study aimed to assess the relationships between lipoprotein ratios and ir in pcos women. materials and methods: thirty six infertile women with pcos selected based on androgen excess society (aes) criteria and 29 healthy women matched for age were recruited to this case-control study. after physical measurements, fasting serum glucose (glu), insulin and lipid profile levels [triglycerides (tgs), total cholesterol (tc), low-density lipoproteincholesterol (ldl-c) and high-density lipoprotein-cholesterol (hdl-c)] were measured, while lipoprotein ratios (tc/hdl-c, ldl-c/hdl-c, tg/hdl-c) were calculated. ir was also calculated using homeostasis model assessment (homa)-ir. the optimal cutoffs of lipoprotein ratios in relation to homa-ir were calculated based on the receiver operating characteristics (roc) curve analysis using the area under curve (auc). results: waist circumference (wc), insulin levels, homa-ir, tg levels, and all lipoprotein ratios were significantly higher, while hdl-c was lower in pcos group as compared to healthy controls. all lipoprotein ratios, tg levels, and wc are significantly correlated with insulin levels and homa-ir. among lipoprotein ratios, the highest auc of the roc belonged to tg/hdl-c ratio with sensitivity of 63.6% and specificity of 84.4% (tg/hdl-c>3.19) as a marker of ir in infert ile pcos women. conclusion: lipoprotein ratios, particularly tg/hdl-c, are directly correlated with insulin levels and can be used as a marker of ir (homa-ir) in infertile pcos patients.