The visceral adiposity index as a predictor of insulin resistance in young women with polycystic ovary syndrome

Abstract

Objective: Visceral fat accumulation is more strongly related to insulin resistance than to excess total adiposity. The visceral adiposity index (VAI) has recently been suggested as an indicator of the visceral adiposity measured by magnetic resonance imaging. To evaluate whether the VAI could replace visceral computed tomography (CT) scanning and predict insulin resistance in young women with polycystic ovary syndrome (PCOS) was presented. Design and Methods: One hundred and eighty Korean women aged 16-41 years who were diagnosed with PCOS using the Rotterdam criteria were included. The VAI was derived from a formula using body mass index, waist circumference, triglycerides, and high-density lipoprotein cholesterol. Visceral adiposity was defined as a visceral fat area (VFA) measuring > 100 cm 2 by CT scanning. Insulin sensitivity was evaluated by insulinmediated glucose utilization (M value), which was obtained using a euglycemic hyperinsulinemic clamp. Results:The VAI positively correlated with VFA, the visceral-to-subcutaneous fat ratio, and systolic and diastolic blood pressure, and negatively correlated with the M value. In a linear regression analysis, the VAI was an independent determinant of the insulin sensitivity after controlling for age, systolic blood pressure, fasting glucose, fasting insulin, and testosterone levels. In a logistic regression analysis, the VAI odds ratio was 3.5 (95% CI 1.2-9.8) for predicting visceral adiposity after controlling for the various metabolic parameters and testosterone. Conclusion: The VAI can replace visceral CT scanning as a marker for visceral adiposity, and it predicts insulin resistance in young women with PCOS.

Does visceral adiposity index signify early metabolic risk in children and adolescents?: Association with insulin resistance, adipokines, and subclinical inflammation

“…In this context, visceral adiposity index (VAI)-a novel index derived from anthropometric (BMI and WC) and lipid parameters-has been shown to be associated with visceral adipose tissue and, moreover, with adipokine levels, mainly adiponectin, insulin resistance, and glucose disturbances in adults (12)(13)(14)(15). In addition, this index seems to have predictive value in terms of an increased risk for cardiovascular events (13) and has served as a marker of insulin resistance in several different nosologic entities (16)(17)(18)(19)(20)(21). Furthermore, our group recently reported, for the first time, the strong relationship of VAI with adipose tissue secretion and with functional glycemic disorders (22).…”

Visceral adiposity index correlation with Rotterdam criteria in patients with polycystic ovary syndrome

“…13 These finding indicated that hyperandrogenemia leads to visceral obesity and adipose tissue dysfunction cystic ovarian disease patients.…”

“…10 Recent studies evaluated VAI in women with PCOS and reported that VAI correlated with insulin resistance, differentiate the "metabolically healthy polycystic ovary syndrome" from the "metabolically unhealthy polycystic ovary syndrome" Also VAI replace visceral CT scan as a marker for visceral adiposity. [11][12][13] VAI is considered a predictor of clinical severity and therapeutic outcome of PCOS.…”

“…15 PCOS is characterized by hyperandrogenemia, Insulin resistance, chronic anovulation, and polycystic ovary morphology. 16 Hyperandrogenemia is the biochemical hallmark of PCOS. 17 Previous studies hypothesized that hyperinsulinemia causes hyperandrogenemia and anovulation in PCOS.…”

“…17 Visceral adiposity index is a marker of ATD and correlated with insulin resistance in PCOS. 13 Relation between VAI with hyperandrogenism and anovulation in PCOS is unclear. So the evaluation of this relationship will be valuable in order to evaluate of VAI as marker of the main criteria of polycystic ovary syndrome, not ATD alone.…”