International Journal of Clinical Obstetrics and Gynaecology

Background: Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder that influences women’s reproductive, metabolic, and psychological health globally. While extensive metabolomics studies have been conducted in Western and East Asian populations, limited data exist for South Indian women, who may exhibit unique metabolic profiles due to ethnic, dietary, and lifestyle differences.

Objective: The study aimed to analyze serum metabolomic profiles of South Indian women with PCOS in order to identify population-specific diagnostic biomarkers and gain insights into altered metabolic pathways.

Methods: A case-control study was conducted with 50 PCOS patients and 50 age-matched healthy controls. An untargeted serum metabolomics approach was employed using gas chromatography–mass spectrometry (GC–MS). Multivariate models, including PCA and PLS-DA, were used for group discrimination. Identified metabolites were subjected to pathway enrichment analysis and compared with global datasets.

Results: Our results showed that 8 metabolites were significantly dysregulated in PCOS women. Heptadecanoic acid, Taurine, 4-Hydroxyproline, and compound A were upregulated, while 2-Palmitoylglycerol, 1-Monopalmitin, Glycerol monostearate, and compound B were downregulated. Enrichment analysis of 62 dysregulated metabolites revealed key disruptions in amino acid metabolism (phenylalanine, tyrosine, tryptophan, glycine, serine, threonine), carbohydrate metabolism (starch, sucrose), and glutathione and dicarboxylate pathways.

Conclusion: This study highlights distinct metabolic signatures in South Indian women with PCOS, reflecting alterations in lipid, amino acid, and energy metabolism. These results offer new perspectives on the metabolic characteristics of PCOS in this population and may contribute to the identification of population-specific biomarkers for enhanced diagnosis and therapeutic strategies.