Evaluation of Novel Obesity and Lipid-Related Indices as Indicators for the Diagnosis of Metabolic Syndrome and Premetabolic Syndrome in Chinese Women with Polycystic Ovary Syndrome

Abstract

Objectives. According to the International Diabetes Federation (IDF) criteria, previous studies in Chinese women with polycystic ovary syndrome (PCOS) reported a low prevalence of metabolic syndrome (MS); however, the same population predisposed to developing pre-MS. Early identification and treatment of individuals with MS and pre-MS are imperative to prevent their adverse consequences. Moreover, fasting plasma glucose (FPG) was not accurate in detecting pathoglycemia in women with PCOS as they have shown characteristically postprandial abnormalities in the carbohydrate metabolism. Therefore, we aimed to compare the discriminative performance of various indices for identifying MS and pre-MS/MS (pre-MS and MS) using the updated Chinese Diabetes Society (uCDS) criteria in Chinese women with PCOS. Methods. 1083 Chinese women with PCOS were included in this study. We measured and evaluated 8 indices in all individuals. Based on the uCDS criteria for MS, patients who had no less than two components of MS but did not meet the criteria for the diagnosis of MS were considered as having pre-MS. Receiver operating characteristic (ROC) curves and the area under ROC curves (AUCs) levels were used to assess the accuracy of each index in detecting MS and pre-MS/MS. Results. Among the 8 indices assessed, the lipid accumulation product (LAP) provided the highest AUCs for detecting MS and pre-MS/MS, followed by CVAI, WTI, VAI, TyG, TG/HDL, WC, and BMI. The optimal cutoff points determined for LAP were 45.13 (sensitivity 88.0%, specificity 88.4%, and Youden index 0.764) for MS and 28.01 (sensitivity 87.5%, specificity 80.7%, and Youden index 0.681) for pre-MS/MS, respectively. Conclusions. uCDS criteria are reasonably more suitable for detecting MS and pre-MS in Chinese women with PCOS. Based on this criterion, LAP is the best index for the diagnosis of MS and pre-MS/MS in Chinese women with PCOS, out of the 8 obesity and lipid-related indices assessed.

Assessing the predictive value of insulin resistance indices for metabolic syndrome risk in type 2 diabetes mellitus patients

“…Similarly, Endukuru et al demonstrated that WTI had the highest predictive ability for detecting low high-density lipoprotein cholesterol (HDL-C), elevated blood pressure, and high triglyceride levels in women compared to other indices 43 . Several studies have also demonstrated the high predictive capacity of WTI for discriminating MetS 44 , 45 . The METS-IR was developed by Chavolla et al to evaluate insulin sensitivity, validated against the euglycemic–hyperinsulinemic clamp.…”

Evaluation of novel obesity- and lipid-related indices as predictors of abnormal glucose tolerance in Chinese women with polycystic ovary syndrome

“…PCOS adults (aged 20–41 years) were diagnosed when meeting at least two out of the following three criteria [ 4 , 7 ] (PCOS adolescents (aged 13–19 years) required the presence of all three criteria) [ 21 ]: (i) olig- and/or anovulation (i.e. eight or fewer menstrual cycles in a year or menstrual cycles more than 35 days in length) (ii) clinical hyperandrogenism (i.e.…”

“…All the recruited patients underwent 75-g OGTT and anthropometric measurements. All parameters were measured, as previously described [ 7 , 22 ].…”

“…Polycystic ovary syndrome (PCOS), a very common endocrine disorder, impacts 5-10% of women in their reproductive age [4]. A more meaningful screening for abnormal glucose tolerance (AGT) is warranted in women with PCOS as they show an increased prevalence of disturbances of glucose metabolism compared with the general population and have shown characteristically postprandial abnormalities in glucose metabolism [5][6][7].…”

What is the best anthropometry index to evaluate the risk of metabolic abnormalities in Chinese adults?

“…In a series of studies, percent body fat and fat mass index were found to be more valuable in predicting metabolic abnormalities than traditional measurements such as BMI and WC. 12,13 In addition, images measured with water-fat magnetic resonance imaging, dual-energy X-ray absorptiometry, and ultrasound can also reflect whole-body composition in a detailed and intuitive fashion; however, these approaches are not suitable for routine detection because of their high cost, complexity, and radioactivity. 14 Identification of a recognised index that can distinguish obesity as well as evaluate prediction of metabolic abnormalities has been This study was conducted in accord with the principles of the Declaration of Helsinki and with the approval of the institutional ethics committees of Huadong Sanatorium and Wuxi People's Hospital to collect clinical data with informed consent.…”