Indirect Predictors of Visceral Adipose Tissue in Women with Polycystic Ovary Syndrome: A Comparison of Methods

Abstract

Visceral adipose tissue (VAT) accumulation, is a part of a polycystic ovary syndrome (PCOS) phenotype. Dual-energy x-ray absorptiometry (DXA) provides a gold standard measurement of VAT. This study aimed to compare ten different indirect methods of VAT estimation in PCOS women. The study included 154 PCOS and 68 age- and BMI-matched control women. Subjects were divided into age groups: 18–30 y.o. and 30–40 y.o. Analysis included: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist/height 0.5 (WHT.5R), visceral adipose index (VAI), lipid accumulation product (LAP), and fat mass index (FMI). VAT accumulation, android-to-gynoid ratio (A/G), and total body fat (TBF) was measured by DXA. ROC analysis revealed that WHtR, WHT.5R, WC, BMI, and LAP demonstrated the highest predictive value in identifying VAT in the PCOS group. Lower cut-off values of BMI (23.43 kg/m2) and WHtR (0.45) were determined in the younger PCOS group and higher thresholds of WHtR (0.52) in the older PCOS group than commonly used. Measuring either: WHtR, WHT.5R, WC, BMI, or LAP, could help identify a subgroup of PCOS patients at high cardiometabolic risk. The current observations reinforce the importance of using special cut-offs to identify VAT, dependent on age and PCOS presence.

Association between Three Waist Circumference-Related Obesity Metrics and Estimated Glomerular Filtration Rates

“…Regarding the association between eGFRs and the WHt.5R, WC, WHtR, and the WHt.5R were good predictors of the outcomes during metabolic studies of middle-aged and elderly Chinese populations [ 16 ]. The WHt.5R had the best predictive ability when identifying visceral adipose tissue, which could be observed with polycystic ovary syndrome [ 15 ]. Interestingly, two studies have insisted that the WHt.5R is the strongest predictor of cardiometabolic risk, and that the second strongest predictor is WHtR; other metrics included WC, BMI, and WHR [ 6 , 30 ].…”

“…Interestingly, two studies have insisted that the WHt.5R is the strongest predictor of cardiometabolic risk, and that the second strongest predictor is WHtR; other metrics included WC, BMI, and WHR [ 6 , 30 ]. Additionally, three other studies reported that the WHtR and WHt.5R were good predictors of outcomes [ 5 , 15 , 31 ]. In relation to these five studies, our results showed that the WHtR was the strongest WC-related obesity metric when compared with BMI or residual BMI for both sexes.…”

“…Moreover, previous studies that used the WHtR have focused on its association with cardiometabolic diseases. The waist-to-height 0.5 ratio (WHt.5R) is a relatively newly established WC-related obesity metric [ 5 , 6 , 14 , 15 , 16 ]; however, its association with renal function has not yet been tested.…”

Adiponectin levels and its relation with insulin secretion and insulin sensitivity in a group of sub-Saharan African women with polycystic ovary syndrome

“…In our study, we found that WTH was independent factor associated with PCOS and have the best discriminatory power in predicting PCOS with an AUC of 0.76. One study showed that it can be used as indirect predictors of visceral obesity in women with PCOS [ 26 ]. Therefore, this abdominal obesity could cause additional disturbances in metabolic and hormonal parameters in PCOS [ 27 ].…”

Are patients with polycystic ovary syndrome more prone to irritable bowel syndrome?

“…PCOS is associated with an increased risk of insulin resistance (IR), hyperinsulinemia, type 2 diabetes mellitus (T2DM), dyslipidemia, obesity and cardiovascular diseases (CVDs) (5,6). Studies on the complexity of this condition have suggested that PCOS patients present with gastrointestinal (GI) disturbances, including abdominal pain, constipation, or bloating, more often than healthy women (7).…”