OXIDATIVE STRESS-INSULIN RESISTANCE AXIS IN PCOS: PREVALENCE, CORRELATION, AND IMPLICATIONS FOR RISK STRATIFICATION IN RESOURCE-LIMITED HEALTHCARE SETTINGS
Author(s)
Manoj Kumar Mudigubba, MPH, PharmD, PhD1, Queeni Sharoon Melam, PharmD2, Jashuva T, PharmD3.
1Associate Professor & HoD, Raghavendra Institute of Pharmaceutical Education and research, Anantapur, India, 2Raghavendra Institute of Pharmaceutical Education and research, Anantapur, India, 3Raghavendra Institute of Pharmaceutical Education & Research (RIPER), Anantapur, India.
1Associate Professor & HoD, Raghavendra Institute of Pharmaceutical Education and research, Anantapur, India, 2Raghavendra Institute of Pharmaceutical Education and research, Anantapur, India, 3Raghavendra Institute of Pharmaceutical Education & Research (RIPER), Anantapur, India.
OBJECTIVES: Insulin resistance (IR) and oxidative stress (OS) are key metabolic determinants contributing to the long‑term clinical and economic burden of Polycystic Ovary Syndrome (PCOS). Early identification of these abnormalities is essential for optimizing outcomes and reducing downstream healthcare utilization. This study quantified the prevalence of IR and OS among women with PCOS in a secondary care setting and evaluated the association between total antioxidant capacity (TAC) and insulin resistance indices to inform risk‑stratification strategies relevant to resource‑constrained health systems.
METHODS: A cross‑sectional observational study was conducted over six months at a secondary care hospital in Andhra Pradesh. Women aged 18-45 years with PCOS diagnosed using Rotterdam criteria were enrolled through consecutive sampling (N = 75). Fasting plasma glucose (enzymatic colorimetry), fasting serum insulin (ECLIA), and TAC (FRAP assay) were measured. IR was defined as HOMA‑IR ≥ 2.0. Statistical analyses included descriptive statistics, Shapiro-Wilk normality testing, Spearman’s correlation, and multivariable logistic regression (IBM SPSS v27). The analytic approach emphasized measurement validity, early metabolic risk detection, and implications for cost‑efficient diagnostic pathways.
RESULTS: Participants had a mean age of 27.48 ± 4.97 years and mean BMI of 22.87 ± 2.50 kg/m². Severe IR was observed in 50.7% of subjects (mean HOMA‑IR 2.83 ± 1.07). TAC values were significantly reduced (median 1.00 mmol/L; Shapiro-Wilk p < 0.001), indicating substantial oxidative imbalance. TAC demonstrated a significant negative correlation with fasting insulin (r = -0.246, p = 0.033), while the correlation with HOMA‑IR was not statistically significant (r = -0.202, p = 0.083). The regression model predicting TAC was significant (R² = 0.134, p = 0.016), suggesting early metabolic interaction between OS and hyperinsulinaemia.
CONCLUSIONS: Women with PCOS demonstrate concurrent oxidative stress and insulin dysregulation despite normoglycaemia. TAC-insulin association reflects early metabolic disturbance. Incorporating TAC and insulin measures may strengthen early risk stratification in resource‑limited secondary care settings.
METHODS: A cross‑sectional observational study was conducted over six months at a secondary care hospital in Andhra Pradesh. Women aged 18-45 years with PCOS diagnosed using Rotterdam criteria were enrolled through consecutive sampling (N = 75). Fasting plasma glucose (enzymatic colorimetry), fasting serum insulin (ECLIA), and TAC (FRAP assay) were measured. IR was defined as HOMA‑IR ≥ 2.0. Statistical analyses included descriptive statistics, Shapiro-Wilk normality testing, Spearman’s correlation, and multivariable logistic regression (IBM SPSS v27). The analytic approach emphasized measurement validity, early metabolic risk detection, and implications for cost‑efficient diagnostic pathways.
RESULTS: Participants had a mean age of 27.48 ± 4.97 years and mean BMI of 22.87 ± 2.50 kg/m². Severe IR was observed in 50.7% of subjects (mean HOMA‑IR 2.83 ± 1.07). TAC values were significantly reduced (median 1.00 mmol/L; Shapiro-Wilk p < 0.001), indicating substantial oxidative imbalance. TAC demonstrated a significant negative correlation with fasting insulin (r = -0.246, p = 0.033), while the correlation with HOMA‑IR was not statistically significant (r = -0.202, p = 0.083). The regression model predicting TAC was significant (R² = 0.134, p = 0.016), suggesting early metabolic interaction between OS and hyperinsulinaemia.
CONCLUSIONS: Women with PCOS demonstrate concurrent oxidative stress and insulin dysregulation despite normoglycaemia. TAC-insulin association reflects early metabolic disturbance. Incorporating TAC and insulin measures may strengthen early risk stratification in resource‑limited secondary care settings.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH92
Topic
Clinical Outcomes, Epidemiology & Public Health, Real World Data & Information Systems
Disease
Reproductive & Sexual Health