We thank Dr Raheja for constructive comments1 regarding the interpretation of serum uric acid levels across different phenotypes of PCOS.
As noted in the letter, serum uric acid levels in PCOS are closely linked to metabolic factors such as obesity, insulin resistance, and dyslipidaemia. We fully agree that adiposity plays an important role in uric acid metabolism. In our cohort,2 serum uric acid levels demonstrated significant positive correlations with both body mass index (BMI) and waist circumference. In addition, most hyperuricemic cases were observed among overweight and obese individuals, particularly within Phenotype A. These findings indicate that increased metabolic burden likely contributes substantially to elevated serum uric acid levels in PCOS.
The letter suggests that phenotype-related differences might disappear after adjustment for BMI. However, BMI-adjusted multivariable analyses were not performed in the present study; therefore, such an inference cannot be directly drawn from our reported data. Our analysis was designed as a phenotype stratified descriptive evaluation rather than a fully adjusted causal model. Accordingly, our conclusions were intentionally framed to reflect the association between serum uric acid levels and the metabolic characteristics accompanying certain PCOS phenotypes, rather than implying that phenotype independently determines serum uric acid levels. We agree that multivariable models incorporating metabolic covariates such as BMI, waist circumference, insulin resistance indices, and lipid parameters would further clarify the independent determinants of serum uric acid levels.
We also acknowledge the limitation raised regarding the absence of obese controls that prevented direct comparison between obese PCOS patients and obese controls.
Footnotes
How to cite this article: Akkus C, Oner O, Okan Kilic A, Ucar Toros M, Duran C. Authors’ response. Indian J Med Res. 2026;164:501. doi: 10.25259/IJMR_3094_2026.
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Use of Artificial Intelligence (AI)-Assisted Technology for manuscript preparation
The authors confirm that there was no use of Artificial Intelligence (AI)-Assisted Technology for assisting in the writing or editing of the manuscript and no images were manipulated using the AI.
References
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