Visceral adiposity index among young girls with PCOS and its association with phenotypes and metabolic risk
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20180164Keywords:
Adolescents, Body mass index, Metabolic syndrome, PCOS, Visceral Adiposity IndexAbstract
Background: Polycystic Ovarian Syndrome (PCOS) is a growing endocrine-metabolic disease in India. Visceral Adiposity Index (VAI) is a surrogate marker of visceral adipose dysfunction and can be used as a useful predictor of unhealthy PCOS phenotypes in low resource settings. No cut-off has been assessed among Indian population.
Methods: Secondary data from 106 diagnosed girls with PCOS and 121 controls was analysed to estimate (i) VAI and BMI among different phenotypes (ii) risk of metabolic disorders using VAI among different phenotypes of PCOS and (iii) compare the overall diagnostic performance (for metabolic syndrome) of VAI, BMI and waist circumference.
Results: Majority of the girls in the sample considered for analysis were lean PCOS (61%). Mean VAI among PCOS (3.02) was significantly higher than normal controls (2.81). Classic and Mild Phenotypes had high VAI. A unit increase in VAI score was found associated with 5.23 times higher risk of metabolic syndrome (AOR: 5.23, 95% CI: 2.261-12.086). A higher VAI with cut off value of 2.73 could predict risk of metabolic syndrome among PCOS cases, unlike the cutoff among Caucassian population of 1.67. The cut-off for the non- obese group was even higher i.e. 2.81.
Conclusions: Given that Indians are genetically more prone to have excess visceral fat the cut-offs for measuring adiposity also needs to be re-defined. The findings of this small sample throws light on the prevalence of visceral adiposity among lean girls with PCOS emphasizing the need to also screen them for metabolic syndrome, educate them about these complications and motivate them to practice healthy lifestyles.
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References
Gallagher D, Heymsfield SB, Heo M, Jebb SA, Murgatroyd PR, Sakamoto Y. Healthy percentage body fat ranges: An approach for developing guidelines based on body mass index. Am J Clin Nutr. 2000;72:694‑701.
Despre´s JP. What is “metabolically healthy obesity”?: from epidemiology to pathophysiological insights. 2012;97(7):2283-5.
Huxley R, Mendis S, Zheleznyakov E, Reddy S, Chan J. Body mass index, waist circumference and waist: hip ratio as predictors of cardiovascular risk: a review of the literature. Eu J Clin Nutr. 2010;64(1):16-22.
Shuster A, Patlas M, Pinthus JH, Mourtzakis M. The clinical importance of visceral adiposity: critical review of methods for visceral adipose tissue analysis. Br J Radiol. 2012;85(1009):1-10.
Amato MC, Giordano C. Visceral adiposity index: an indicator of adipose tissue dysfunction. Int J Endocrinol. 2014:2014.
Oh JY, Sung YA, Lee HJ. The visceral adiposity index as a predictor of insulin resistance in young women with polycystic ovary syndrome. Obesity. 2013;21(8):1690-4.
Amato MC, Verghi M, Galluzzo A, Giordano C. The oligomenorrhoic phenotypes of polycystic ovary syndrome are characterized by a high visceral adiposity index: a likely condition of cardiometabolic risk. Human Reprod. 2011;26(6):1486-94.
Joshi B, Mukherjee S, Patil A, Purandare A, Chauhan S, Vaidya R. A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India. Indian J Endocrinol Metabol. 2014;18(3):317.
Amato MC, Guarnotta V, Forti D, Donatelli M, Dolcimascolo S, Giordano C. Metabolically healthy polycystic ovary syndrome (MH-PCOS) and metabolically unhealthy polycystic ovary syndrome (MU-PCOS): a comparative analysis of four simple methods useful for metabolic assessment. Human Reprod. 2013;28(7):1919-28.
Misra A, Chowbey P, Makkar BM, Vikram NK, WasirJS, Chadha D. Consensus statement for diagnosis of obesity, abdominal obesity and the metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Physicians India 2009;57:163-70.
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome. Circ. 2005;112(17):2735-52.
Abarca-Gómez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128· 9 million children, adolescents, and adults. The Lancet. 2017;390(10113):2627-42.
Oliveros E, Somers VK, Sochor O, Goel K, Lopez-Jimenez F. The concept of normal weight obesity. Progress in Cardiovascular Diseases. 2014;56(4):426-33.
Hajer GR, van Haeften TW, Visseren FL. Adipose tissue dysfunction in obesity, diabetes, and vascular diseases. Eu Heart J. 2008;29(24):2959-71.
Androulakis II, Kandaraki E, Christakou C, Karachalios A, Marinakis E, Paterakis T, et al. Visceral adiposity index (VAI) is related to the severity of anovulation and other clinical features in women with polycystic ovary syndrome. Clin Endocrinol. 2014;81(3):426-31.