Utility of Visceral Adipocity Index (VAI)  and Lipid Accumulation Products (LAP) to define metabolically-unhealthy (MU) PCOS  in Asian Indian women-  a cross sectional study

 

ABSTRACT

 

• Aim: To evaluate Visceral Adiposity Index (VAI) and Lipid Accumulation Product (LAP) in women with polycystic ovary syndrome (PCOS) and to correlate them with metabolic and endocrine markers. The study also evaluated these parameters among different PCOS phenotypes and to determine their usefulness to define metabolically healthy (MH-PCOS) and metabolically unhealthy PCOS (MU-PCOS).
• Methods: The cross-sectional study was conducted at a tertiary care referral center in India. Two hundred PCOS women were included for the study  and was divided into MH-PCOS and MU-PCOS by modified NCEP criteria. VAI and LAP calculated, correlated with metabolic and endocrine parameters.
• Results: VAI and LAP had good ability to correctly discriminate MU-PCOS from MH-PCOS [AUC (95%CI): 0.89 (0.82-0.95)] and [AUC (95% C.I. (0.81-0.92) =0.86] using ROC respectively. Sensitivity of VAI and LAP corresponding to optimal cut of ≥2.76 and ≥48.06 (Youden) were 84.09% and 79.55% respectively. Similarly, specificity of VAI and LAP were 85.26% and 79.49% respectively. VAI has a positive predictive value of 61.7%; [95% CI (23.7%-40.3%)] and a negative predictive value of [95%; 95% CI (88%-99.1%)]. LAP has a positive predictive value of 53%; [95% CI (40.3%-65.4%)] and a negative predictive value of 93.3%; [95% CI (87.6%-96.9%)]. PCOS women having VAI ≥2.76 had 19.3 times [(95%CI: 6.50-57.70)] more chance of developing Metabolic Syndrome. PCOS women having LAP (≥48.06) have 3.7 times [(95%CI: 1.35-10.60)] more odds. There was no difference between ROC curves of VAI and LAP (P=0.32).
• Conclusion: VAI cut-off ≥ 2.76 and LAP with cut off of ≥ 48.06 may be used as markers for predicting metabolic syndrome among PCOS women.

Key words: Metabolic Syndrome, phenotype, Polycystic Ovary Syndrome, risk factor, Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP).