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Reproductive Endocrinology

SAT-187 - The Additive Value of Waist to Height Ratio in the Assessment of Women with Polycystic Ovary Syndrome. Evidence from A Large European Cohort.

Saturday, June 13, 2026
9:30 AM - 4:30 PM CT
Location: ENDOExpo; Poster Floor
Disclosure(s):
Rodis D. Paparodis, MD, FNLA: .NovoNordisk: Advisory Board (), Speakers' Bureau (); Ascendis Pharma: Advisory Board (), Grant Recipient (), Honorarium Recipient (); Sanofi: Advisory Board ()


Background: Women suffering from PCOS display a variety of metabolic and hormonal abnormalities. Waist to height ratio (WHtR,), is considered as a valuable predictor of cardiovascular risk and central obesity.
Aim of the study: To assess the association of WHtR with metabolic/hormonal profile in PCOS.

Methods: Data from 2201 PCOS women, mean age 25.0 years (21–29), BMI 24.7kg/m² (21.3–30.80) were analyzed. Participants were classified into three WHtR categories according to the established cut-offs (A: < 0.50, B: 0.50–0.59, C: ≥0.60). Findings are presented before and after adjustment for age and BMI.

Results: A gradual statistically significant increase was observed among subgroups regarding HOMA-IR [A:1.5 (0.9–2.3), B:2.7 (1.6–4.0), C:4.2 (2.6–6.3)] and the existence of impaired glucose tolerance (IGT) [A:7.3%, B:12.4%, C:24.0%], (p for trend < 0.001). The relationship of HOMA-IR with WHtR remained statistically significant (p < 0.001) even after adjustment for age and BMI. These subgroups were also associated with a progressively adverse lipid profile, characterized by higher triglyceride [A: 78 (58–102), B:89 (67–111), C: 96 (75–142)mg/dl] and LDL cholesterol levels [A: 108 (86–133), B:114 (94–139), C:118.0 (98–133) mg/dl] and lower HDL cholesterol concentrations [A: 51(43–61), B:51 (42–57), C:45 (40–54)mg/dl], with strong linear trends across WHtR strata. Total cholesterol showed only modest differences. Notably, the associations with triglycerides and HDL cholesterol persisted after adjustment for age and BMI (p for trend < 0.001). Considering, hormonal profile, subgroups based on WHtR categories were associated with a progressive increase in free androgen index (FAI) [A:4.97 (3.07–7.66), B:7.49 (4.54–11.11), C:9.38 (6.00–13.90)] and the prevalence of hirsutism [A:55.5%, B:61.8%, C:69.3%] (p for trend < 0.001). Total testosterone levels showed a modest, but significant increase across WHtR strata, whereas DHEAS, D4 and 17OP concentrations did not differ significantly. Gonadotropins exhibited an inverse association with WHtR, with lower LH and FSH levels observed in higher WHtR categories, while TSH showed only a weak trend. In multivariate analyses, sugbroups were strongly associated with increased FAI values in a graded manner, and these associations remained statistically significant after adjustment for age and BMI (p < 0.001).

Conclusions: Multivariate analysis showed that WHtR constitutes a solid denominator of insulin resistance, dyslipidemia and hyperandrogenemia even after adjustment of age and BMI. These findings suggest that WHtR captures a distinct aspect of PCOS pathophysiology as it integrates both metabolic and androgenic interaction in PCOS and emerges as a pragmatic anthropometric marker for early metabolic risk stratification in PCOS.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*