AUTONOMIC DYSFUNCTION AND METABOLIC DYSFUNCTION IN WOMEN WITH POLYCYSTIC OVARY SYNDROME: A COMPARATIVE STUDY

Abstract

Background: Polycystic Ovary Syndrome (PCOS) is an endocrine disorder affecting women during their reproductive years, often involving metabolic and autonomic irregularities. This study aimed to evaluate and compare autonomic function and insulin resistance in women with PCOS versus healthy controls, also examining the influence of Body Mass Index (BMI).

Methods: A comparative cross-sectional study was conducted on 100 female participants aged 18-30 years, divided into healthy controls and PCOS based on Rotterdam criteria. Autonomic function was assessed via Heart Rate Variability (HRV). Metabolic health was evaluated through fasting blood sugar, fasting insulin and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Data was stratified by BMI categories to determine the impact of adiposity on these physiological markers.

Result: Women with PCOS shows significant autonomic imbalance, characterized by reduce parasympathetic activity (decreased Percentage of Successive NN Intervals that differ by more than 50ms (pNN50) and (HF) High Frequency) and sympathetic dominance (increased LF/HF ratio) compared to controls (p<0.001). Metabolically, PCOS group showed higher fasting insulin (17.1±2.6 vs. 6.9 ± 1.3) and HOMA-IR (4.5±0.9 vs. 1.5 ±0.4) indicating increased insulin resistance. BMI has a direct relation with the severity of insulin resistance and sympathetic reactivity.

Conclusion: The findings suggest that PCOS is a multisystem condition defined by a self-perpetuating cycle of sympathetic over activity and insulin resistance. Since this distribution persist even in non-obese patient but worsen with weight gain, early screening of cardiovascular and metabolic risk helps to prevent long-term complications.