Objective To understand metabolic and body composition characteristics of obese and lean PCOS (polycystic ovarian syndrome) women so as to provide scientific evidence for targeted weight management guidance among PCOS patients with different BMI (body mass indexes) at later stages.

Methods PCOS patients who were first diagnosed in the gynecologic endocrine diagnosis and treatment center of Hunan maternal and child health hospital from January 2019 to October 2020 were recruited in this cross-sectional study. Their metabolic indexes and body composition indexes were recorded, the metabolic characteristics of PCOS patients with different BMI were compared, and the relationship between metabolic indexes and body composition was analyzed through Pearson correlation analysis.

Results A total of 219 PCOS cases were involved in this study. 78 cases were lean or normal, accounting for 35.6%, and 141 cases were overweight or obese, accounting for 64.4%. The incidence of FPG (fasting plasma glucose), FINS (fasting insulin), HOMA-IR (homeostasismodel assessment-insulin), TG (triglyceride), TC (total cholesterol), LDL (low density lipoprotein cholesterol), UA (uric acid) exceeding upper limit and HDL (high density lipoprotein cholesterol) below the lower limit were different among PCOS patients with different BMI (P < 0.05). The mean values of FPG, FINS, HOMA-IR, TG, TC, HDL, LDL and UA elevated (P < 0.05), the mean value of HDL decreased (P < 0.05), and the mean value of TC were not different (P > 0.05) with BMI increased. FPG, FINS, HOMA-IR, TG, UA were positively correlated with body fat content, body fat ratio, visceral fat area, and waist hip ratio (P < 0.05), while HDL was positively correlated with skeletal muscle content, and skeletal muscle ratio (P < 0.05). FPG was negatively correlated with skeletal muscle ratio, FINS, HOMA-IR, TG, UA were negatively correlated with skeletal muscle content and skeletal muscle ratio, while HDL was negatively correlated with body fat content, body fat ratio, visceral fat area, and waist to hip ratio (P < 0.05).

Conclusion Even the PCOS patients with lean and normal body mass may have abnormal metabolic indexes. The reasons for that are less skeletal muscle mass but relatively higher body fat mass, increased waist-to-hip ratio and visceral fat area.