Materials and Methods: A case-control study was conducted on 77 women with PCOS and 73 healthy controls aged between 18 and 49 years. Blood samples were obtained for the determination of plasma total homocysteine (tHcy), total cholesterol (TC), triglycerides (TG), low- and high-density lipoprotein, TC/high-density lipoprotein ratio, total testosterone (TT), sex hormone-binding globulin, and free androgen index (FAI). Finally, multivariable logistic regression analysis was performed to identify the independent biochemical markers of PCOS.

Results: The mean differences between cases and controls in tHcy, TG, and sex hormone-binding globulin were statistically significant. tHcy and TG were elevated in cases while sex hormone-binding globulin demonstrated a reduction. All three markers were identified as independent predictors of PCOS in multivariable analysis in addition to a fourth, TT. tHcy is an independent biomarker of PCOS despite a relationship with TG and TC, the former of which is itself an independent biomarker.

Conclusions: In general, overweight women with PCOS had higher levels of tHcy and TG and a lower level of sex hormone-binding globulin compared with healthy controls. The level of tHcy is a marker of PCOS independent of the lipid profile. The differential biochemical profile of women with PCOS and healthy women provides useful hints for the diagnosis of PCOS and thus must be addressed in relation to the risk of cardiovascular disease.