Metabolic disturbances in non-obese women with polycystic ovary syndrome: a systematic review and meta-analysis

Nonobese women with PCOS suffer higher risk of metabolic disturbances including insulin resistance, hyperinsulinemia, impaired glucose tolerance, diabetes, dyslipidemia, and metabolic syndrome compared with nonobese controls.

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Volume 111, Issue 1, Pages 168–177


Shiqin Zhu, M.D., Bingqian Zhang, M.D., Xiao Jiang, M.D., Zeyan Li, M.D., Shigang Zhao, M.D., Ph.D., Linlin Cui, M.D., Ph.D., Zi-Jiang Chen, M.D., Ph.D.



To explore metabolic disturbances in nonobese women with polycystic ovary syndrome (PCOS) compared with nonobese healthy controls.


Systematic review and meta-analysis.


Not applicable.


Nonobese women with PCOS and nonobese healthy controls.



Main Outcome Measure(s)

Prevalence of metabolic disturbances including hyperinsulinemia, insulin resistance (IR), impaired fasting glucose (IFG), impaired glucose intolerance (IGT), prediabetes, dyslipidemia, hypercholesterolemia, hypertriglyceridemia, and low high-density lipoprotein (low-HDL), as well as other metabolic outcomes such as type 2 diabetes mellitus (T2DM), hypertension, metabolic syndrome (Mets), myocardial infarction, stroke, cerebrovascular accident, arterial occlusive disease, and coronary heart disease.


Compared to nonobese controls, nonobese women with PCOS showed a higher prevalence of hyperinsulinemia (odds ratio [OR], 36.27; 95% confidence interval [CI] 1.76–747.12), IR (OR, 5.70; 95% CI 1.46–22.32), IGT (OR, 3.42; 95% CI 1.56–7.52), T2DM (OR, 1.47; 95% CI 1.11–1.93), hypertriglyceridemia (OR, 10.46; 95% CI 1.39–78.56), low-HDL (OR, 4.03; 95% CI 1.26–12.95), and Mets (OR, 2.57; 95% CI 1.30–5.07). No significant difference was observed for IFG, pre-DM, dyslipidemia, hypercholesterolemia, and hypertension. In subgroup analysis, Whites exhibited increased risks of IR, IGT, IFG, T2DM, hypertension, and Mets, whereas no significant metabolic change was found in Asians. No study reported specifically an incidence of myocardial infarction, stroke, cerebrovascular accident, arterial occlusive disease, and coronary heart disease in nonobese women with PCOS.


Nonobese women with PCOS also suffer from metabolic disturbances and the risk of long-term metabolic complications. Further efforts should be made to elucidate underlying mechanisms and possible interventions in the early phase.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.