Association of Insulin Resistance and Elevated Androgen Levels in Patients with Polycystic Ovarian Syndrome (PCOS)

Open Access

Abstract

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women characterized by hyperandrogenism, ovulatory dysfunction, and insulin resistance. Insulin resistance and elevated androgen levels are closely interrelated in PCOS, though their association varies across populations. Objective: The aim of the study was to determine the association between insulin resistance and elevated androgen levels in patients with polycystic ovarian syndrome (PCOS). Methods & Materials: This cross-sectional observational study was conducted at the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from January to December 2024, including 110 women with PCOS selected by purposive sampling. After excluding other endocrine disorders and hormonal therapy, BMI and fasting insulin, glucose, and testosterone were measured; insulin resistance was assessed using HOMA-IR and elevated androgens by laboratory reference ranges. Statistical analysis was performed with p < 0.05 considered significant. Results: The study included 110 women with PCOS, with most aged 21–30 years (61.8%) and a mean age of 26.5 ± 7.2 years. Overweight/obesity was present in 68.2% of participants. Insulin resistance and elevated androgen levels were observed in 65.5% and 70.9% of patients, respectively. A significant association was found between insulin resistance and elevated androgen levels (p < 0.001), with higher fasting insulin, HOMA-IR, and total testosterone in insulin-resistant patients (p < 0.001). Conclusion: Insulin resistance is significantly associated with elevated androgen levels in women with polycystic ovarian syndrome, highlighting a strong interrelated metabolic–endocrine link in its pathophysiology.