Abstract / Summary
Abstract Background Polyendocrine metabolic ovarian syndrome (PMOS) carries a substantial cardiometabolic burden, but its distribution across composite lipid/glycemic indices, capture by conventional global cardiovascular risk scores, and relationship to PMOS phenotype and hyperandrogenism severity remain incompletely characterized, particularly in Sub-Saharan Africa. We examined the cardiometabolic risk profile of Cameroonian women with PMOS, its association with phenotype, and its relationship to hirsutism severity. Methods We conducted a descriptive analytical cross-sectional study with prospective data collection over six months (January–June 2026) in two referral hospitals in Yaoundé, enrolling 69 women aged 18–45 with PMOS diagnosed by Rotterdam (2003) criteria. Four cardiometabolic indices — triglyceride-glucose (TyG) index, atherogenic index of plasma (AIP), LDL/HDL-cholesterol ratio, and non-HDL cholesterol — were categorized using standard thresholds, and the Framingham 10-year cardiovascular risk score was calculated for comparison. Phenotype (A vs. non-A) and metabolic syndrome association was assessed by logistic regression. Hirsutism severity (modified Ferriman–Gallwey, mFG) was correlated with the four indices using Spearman's and partial correlation adjusting for BMI. Results A high-risk AIP (> 0.21) was present in 53.6% of participants and elevated non-HDL cholesterol (≥ 130 mg/dL) in 66.7%, while probable insulin resistance by TyG (> 8.5) occurred in 23.2% and an elevated LDL/HDL ratio (> 3.5) in 8.7%. The Framingham score classified 98.6% as mild risk (< 10%), reflecting the cohort's young age rather than absent cardiometabolic burden. Metabolic syndrome was present in 43.5% (30/69); women with complete Rotterdam phenotype (A) had higher odds of metabolic syndrome than non-A phenotype (49.0% vs. 27.8%), though not significant (OR = 2.50, 95% CI 0.78–8.04, p = 0.124). Among 61 participants with recorded mFG scores, none of the four indices correlated significantly with hirsutism severity (Spearman ρ 0.10–0.23, all p ≥ 0.075), remaining non-significant after BMI adjustment. Conclusion Cameroonian women with PMOS carry a substantial cardiometabolic burden poorly captured by a conventional, age-driven global risk score, trending toward greater severity in the complete (Phenotype A) presentation, though not significantly in this cohort. Hirsutism severity was not associated with this burden. These findings support routine use of composite lipid/glycemic indices, rather than global age-based risk scores or hirsutism severity alone, applied uniformly across PMOS phenotypes.