Visceral adiposity index: Simple Tool for assessing cardiometabolic risk in women with polycystic ovary syndrome

Abstract

Aim: To study visceral adiposity index (VAI) and its association with cardiometabolic risk in different phenotypes of polycystic ovary syndrome (PCOS). Materials and Methods: It is a case–control cross-sectional study where 100 reproductive age (18–35 years) women with PCOS were classified in different phenotypes as per Rotterdam criteria and compared with age and Body mass index (BMI) matched 50 eumenorrheic and nonhirsute women. Various anthropometric, clinical, biochemical, and hormonal parameters were measured in both women with PCOS and controls. VAI was calculated using waist circumference (WC), BMI, serum triglyceride, and High density lipoprotein (HDL) cholesterol levels in all the subjects and compared between cases and controls. Subsequently, women with PCOS were assessed for cardiometabolic risk according to androgen excess society statement 2010 as “at risk” and “at high risk.” Finally, risk was correlated with VAI for all the phenotypes of PCOS. Results: Mean VAI was significantly higher ( P < 0.001) in cases than controls (2.07 vs. 1.27). Mean VAI in phenotype A (O+P+HA), B (O+HA), C (P+HA), and D (O+P) was 2.46, 2.48, 1.47, and 1.70, respectively. A total of 56% of women with PCOS were at risk and 12% at high risk for cardiometabolic disease. Metabolic syndrome was prevalent in 11% of cases and 1% had type 2 diabetes mellitus. Phenotypically, 88% of women with PCOS with phenotype A (O+P+HA), 67% of B (O+HA), 67% of C (P+HA), and 55% of D (O+P) were at increased risk. VAI was found to be positively correlated with WC (r, 0.550), waist to hip ratio (r, 0.295), Homeostasis model assessment of insulin resistance (HOMA IR) (r, 0.455), and cardiometabolic risk (r, 0.399). Also, it was the best factor associated with cardiometabolic risk (area under curve, 0.793). Conclusion: This study concluded that visceral adiposity index can be used as simple and effective tool for assessing the cardiometabolic risk in women with PCOS as higher VAI values were observed in those cases who were at high risk for developing cardiometabolic disorder in future.

The relation of visceral adiposity index and lipid accumulation product with metabolic, anthropometric, and hormonal parameters in patients with polycystic ovary syndrome

“…Review of the literature reveals several studies investigating the relationship of VAI and LAP with cardiometabolic risk factors in women with PCOS. Agrawal et al [28] examined the possible relationship between VAI and cardiometabolic risk factors in patients with PCOS phenotypes classified according to the Rotterdam criteria and in healthy controls. They showed higher mean VAI values in the PCOS group.…”

Elucidating the impact of obesity on hormonal and metabolic perturbations in polycystic ovary syndrome phenotypes in Indian women

“…North India stated phenotype C to be most common [42][43][44]. In contrast, other groups again from North India [45][46][47] as well as East India [48,49] have detailed increased frequency of phenotype A in their populations.…”

“…Another important finding of our study was LAP and VAI were comparable amongst PCOS phenotypes in the total and lean groups, but in the obese group phenotype A showed markedly higher LAP and VAI compared to phenotypes D and C respectively. In addition, recent studies from India have shown that the classic hyperandrogenic phenotypes of PCOS present with elevated VAI [42,61]. Lack of more significant differences in metabolic traits across PCOS phenotypes in obese group suggests that obesity may mask differences in intrinsic harmful metabolic profiles.…”

The Accuracy of Visceral Adiposity Index for the Screening of Metabolic Syndrome: A Systematic Review and Meta-Analysis

“…As a quantitative and easy-to-use clinical surrogate of VAT, VAI has been the focus of many previous studies using it as a promising tool for screening MetS [ 15 , 17 ] and identifying high-risk patients [ 18 ]. However, previous studies have reported variable screening accuracies of VAI for MetS, and it is unclear whether it is justifiable to use VAI as a screening tool for MetS.…”