{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:20:35Z","timestamp":1791951635477,"version":"4.3.4"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Insulin resistance (IR) and metabolic syndrome (MetS) are highly prevalent and pathophysiologically central features of polycystic ovary syndrome (PCOS). However, their assessment is challenged by the limitations of gold-standard diagnostic methods. The clinical utility of the novel triglyceride glucose index - body mass index (TyG-BMI) for predicting IR, MetS, and its association with fertility outcomes in Chinese women with PCOS remains unexplored and warrants investigation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the association between TyG-BMI and IR and MetS, and fertility outcomes in women with PCOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We used data of 855 participants of the Acupuncture and Clomiphene for Chinese Women with Polycystic Ovary Syndrome (PCOSAct) trial. Linear trend tests and logistic regression evaluated relationships between TyG-BMI and anthropometric, hormonal, metabolic, and fertility outcomes. Receiver operating characteristic (ROC) curves assessed TyG-BMI\u2019s predictive value for IR and MetS. RCS analysis was used to examine threshold effects between TyG-BMI and IR, MetS, and ovulation. A likelihood ratio test was further incorporated to validate the model fit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>TyG-BMI was positively association with IR (OR: 2.747, 95% CI: 1.942\u20133.887) and MetS (OR: 4.176, 95% CI: 2.278\u20137.653). TyG-BMI had a strong predictive performance, with AUC<jats:sub>IR<\/jats:sub> of 0.841 and AUC<jats:sub>MetS<\/jats:sub> of 0.899. For fertility outcomes, after adjusting for confounders, only ovulation showed a significant negative association (OR: 0.984, 95% CI: 0.973\u20130.994). The study revealed significant nonlinear associations between TyG-BMI and both IR and MetS, but a linear link with ovulation status. The inflection point occurred at a TyG-BMI of 203. Below this, IR risk increased progressively with TyG-BMI, plateauing above it. Above 203, MetS prevalence continued to increase, while ovulation rates declined inversely.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated TyG-BMI is strongly associated with worsened IR and MetS in PCOS women, serving as a practical screening tool for these conditions, while also demonstrating a potential negative impact on ovulation.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1653636","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T04:13:47Z","timestamp":1758168827000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Triglyceride glucose index - body mass index predicts insulin resistance, metabolic syndrome and associates with impaired ovulation in Chinese women with polycystic ovary 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