DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20162623

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

Mohamed M. Aboelnaga, H. Elshahawy

Abstract


Background: The present research explores the correlation of visceral obesity index with Rotterdam criteria (hyperandrogenism and/or hyperandrogenemia, oligomenorrhea and Ultrasound polycystic ovarian morphology) among Egyptian polycystic ovary syndrome patients.

Methods: We enrolled one hundred female patients with polycystic ovary syndrome with age ranged 18-44 years (mean age   26.83±6.092 years).

Results: VAI very strongly correlated with waist circumference, TG and HDL-c, also moderately correlated with systolic B.P, BMI, HOMA-IR and insulin levels, also we found only insulin, menstrual cycles per year number and FGS were significant predictors of hyperandrogenemia in PCOS patients. Only Ultrasound polycystic ovarian morphology was a significant risk factor for oligomenorrhea in PCOS patients in logistic regression analysis. VAI, TT and Farman gallawy score can significantly predict number of the menstrual cycles per year number (p <0.05). In logistic regression analysis, only oligomenorrhea was a significant independent risk factor for PCOM (p <0.05). In addition, only VAI was a significant independent (p <0.05) risk factor for metabolic syndrome.

Conclusions: VAI was an independent significant predictor for metabolic syndrome in patients with PCOS and a good marker of cardiometabolic risk in PCOS patients. In addition, VAI was significant predictors of annual menusteral cycle but not testosterone levels or polycystic ovarian morphology in PCOS. This study confirms the value of VAI in identification of patient with risk for metabolic syndrome and cardiometabolic risk in PCOS patients, but not found a role for VAI in diagnosis of PCOS.


Keywords


Hyperandrogenism, Oligomenorrhea, PCOS, VAI

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References


Joham AE, Teede HJ, Ranasinha S, Zoungas S, Boyle J. Prevalence of infertility and use of fertility treatment in women with polycystic ovary syndrome: data from a large community-based cohort study. Journal of Women's Health. 2015;24(4):299-307.

Zuo T, Zhu M, Xu W. Roles of oxidative stress in polycystic ovary syndrome and cancers. Oxid Med Cell Longev. 2016;2016:8589318.

Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Human Reproduction. 2004;19(1):41-7.

Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M, et al. Visceral adiposity index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33:920-2.

Amato MC, Giordano C, Pitrone M, Galluzzo A. Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population. Lipids Health Dis. 2011;10:183.

Zhang X, Shu XO, Li H, Yang G, Xiang YB. Visceral adiposity and risk of coronary heart disease in relatively lean Chinese adults. Int J Cardiol. 2013;168:2141-5.

Elisha B, Messier V, Karelis A, Coderre L, Bernard S, Prud'homme D, et al. The visceral adiposity index: relationship with cardiometabolic risk factors in obese and overweight postmenopausal women - a MONET group study. Appl Physiol Nutr Metab. 2013;38:892-9.

Petta S, Amato MC, Di Marco V, Cammà C, Pizzolanti G. Visceral adiposity index is associated with significant fibrosis in patients with non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2012;35:238-47.

Ciresi A, Amato MC, Pizzolanti G, Giordano Galluzzo C. Visceral adiposity index is associated with insulin sensitivity and adipocytokine levels in newly diagnosed acromegalic patients. J Clin Endocrinol Metab. 2012;97:2907-15.

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. Hum Reprod. 2011;26:1486-94.

Bil E, Dilbaz B, Cirik DA, Ozelci R, Ozkaya E, Dilbaz S. Metabolic syndrome and metabolic risk profile according to polycystic ovary syndrome phenotype. J Obstet Gynaecol Res. 2016;42(7):837-43.

Amato MC, Guarnotta V, Forti D, Donatelli M, Dolcimascolo S, Giordano C. etabolically 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. Hum Reprod. 2013;28(7):1919-28.

Oh JY, Sung YA, Lee HJ. The visceral adiposity index as a predictor of insulin resistance in young women with polycystic ovary syndrome. Obesity (Silver Spring). 2013;21(8):1690-4.

Zheng SH, Li XL. Visceral adiposity index as a predictor of clinical severity and therapeutic outcome of PCOS. Gynecol Endocrinol. 2016;32(3):177-83.

Amato MC, Magistro A, Gambino G, Vesco R, Giordano C. Visceral adiposity index and DHEAS are useful markers of diabetes risk in women with polycystic ovary syndrome. Eur J Endocrinol. 2015;172(1):79-88.

Jee-Young Oh, Yeon-Ah Sung and Hye Jin Lee. The visceral adiposity index as a predictor of insulin resistance in young women with polycystic ovary syndrome. Obesity. 2013;21:1690-4.

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 (Oxf). 2014;81(3):426-31.

Nestler JE, Powers LP, Matt DW, Steingold KA, Plymate SR, Rittmaster RS, et al. A direct effect of hyperinsulinemia on serum sex hormone-binding globulin levels in obese women with the polycystic ovary syndrome. J Clin Endocrinol Metab. 1991;72(1):83-9.

Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. Journal of Clinical Endocrinology and Metabolism. 1961;21:1440-7.

The Rotterdam ESHRE/ASRM-sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and longterm health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19:41-7.

Wild RA, Carmina E, Diamanti-Kandarakis E. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the androgen excess and polycystic ovary syndrome (AE-PCOS) society. Journal of Clinical Endocrinology and Metabolism. 2010;95:2038-49.

Tosi F, Di Sarra D, Kaufman JM, Bonin C, Moretta R, Bonora E, et al. Total body fat and central fat mass independently predict insulin resistance but not hyperandrogenemia in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2015;100(2):661-9.

Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocrine Reviews. 2012;3:981-1030.

Fulghesu AM, Angioni S, Belosi C, Apa R, Selvaggi L, Ciampelli M, et al. Pituitary-ovarian response to the gonadotrophin-releasing hormone-agonist test in anovulatory patients with polycystic ovary syndrome: predictive role of ovarian stroma. Clin Endocrinol (Oxf). 2006;65(3):396-401.

Kassi EN, Diamanti-Kandarakis E, Papavassiliou AG. Correlates between hyperinsulinism and hyperandrogenemia? Fertility and Sterility. 2008;89:1033-4.

Panidis D, Tziomalos K, Papadakis E, Chatzis P, Kandaraki EA. Associations of menstrual cycle irregularities with age, obesity and phenotype in patients with polycystic ovary syndrome. Hormones (Athens). 2015;14(3):431-7.

Pasquali R, Pelusi C, Genghini S, Cacciari M, Gamineri A. Obesity and reproductive disorders in women. Hum Reprod Update. 2003;9:359-72.

Kirschner MA, Samojlik E, Drejka M, Szmal E, Schneider G, Ertel N. Androgen-estrogen metabolism in women with upper body versus lower body obesity. J Clin Endocrinol Metab. 1990;70(2):473-9.

Castillo-Martinez L, Lopez-Alvarenga JC, Villa AR, Gonzalez- Barranco J. Menstrual cycle length disorder in 18- to 40-y-old obese women. Nutrition. 2003;19:317-20.

Lambert-Messerlian G, Roberts MB, Urlacher SS, Ah-Ching J, Viali S, et al. First assessment of menstrual cycle function and reproductive endocrine status in Samoan women. Hum Reprod. 2011;26(9):2518-24.

Azziz R, Carmina E, DeWailly D. Position statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006;91:4237-45.

Sirmans SM, Pate KA. Epidemiology, diagnosis, and management of polycystic ovary syndrome. Clinical Epidemiology. 2014;6:1-13.

Allsworth JE, Clarke J, Peipert JF, Hebert MR, CRNP AC, Boardman LA. The influence of stress on the menstrual cycle among newly incarcerated women. Women’s health issues: official publication of the Jacobs Institute of Women’s Health. 2007;17(4):202-9.

Bil E, Dilbaz B, Cirik DA, Ozelci R, Ozkaya E, Dilbaz S. Metabolic syndrome and metabolic risk profile according to polycystic ovary syndrome phenotype. J Obstet Gynaecol Res. 2016;42(7):837-43.

Porter MB. Polycystic ovary syndrome: the controversy of diagnosis by ultrasound. Semin Reprod Med. 2008;26(3):241-51.

Dunaif A. Perspectives in polycystic ovary syndrome: from hair to eternity. J Clin Endocrinol Metab. 2016;101(3):759-68.

Techatraisak K, Wongmeerit K, Dangrat C, Wongwananuruk T, Indhavivadhana S. Measures of body adiposity and visceral adiposity index as predictors of metabolic syndrome among Thai women with PCOS. Gynecol Endocrinol. 2016;32(4):276-80.

Tehrani FR, Rashidi H, Khomami MB, Tohidi M, Azizi F. The prevalence of metabolic disorders in various phenotypes of polycystic ovary syndrome: a community based study in Southwest of Iran. Reprod Biol Endocrinol. 2014;12:89.