Abstract
Visceral adipose tissue (VAT) accumulation, is a part of a polycystic ovary syndrome (PCOS) phenotype. Dual-energy x-ray absorptiometry (DXA) provides a gold standard measurement of VAT. This study aimed to compare ten different indirect methods of VAT estimation in PCOS women. The study included 154 PCOS and 68 age- and BMI-matched control women. Subjects were divided into age groups: 18–30 y.o. and 30–40 y.o. Analysis included: body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), waist/height 0.5 (WHT.5R), visceral adipose index (VAI), lipid accumulation product (LAP), and fat mass index (FMI). VAT accumulation, android-to-gynoid ratio (A/G), and total body fat (TBF) was measured by DXA. ROC analysis revealed that WHtR, WHT.5R, WC, BMI, and LAP demonstrated the highest predictive value in identifying VAT in the PCOS group. Lower cut-off values of BMI (23.43 kg/m2) and WHtR (0.45) were determined in the younger PCOS group and higher thresholds of WHtR (0.52) in the older PCOS group than commonly used. Measuring either: WHtR, WHT.5R, WC, BMI, or LAP, could help identify a subgroup of PCOS patients at high cardiometabolic risk. The current observations reinforce the importance of using special cut-offs to identify VAT, dependent on age and PCOS presence.
Highlights
Visceral adipose tissue (VAT) is a component of total body fat (TBF) responsible for high metabolic activity because it releases many bioactive hormones and molecules [1].Women with polycystic ovary syndrome (PCOS) are at risk for visceral obesity (VO) [2,3].PCOS is a complex, multifaceted disease linked with hyperandrogenism, hyperandrogenisation, oligoovulation, and polycystic ovarian morphology (PCOM) using ultrasound [4].About half of the patients diagnosed with PCOS are obese, according to the classical WorldHealth Organization (WHO)’s definition of body mass index (BMI) [5]
DXAmeasured VAT volume strongly correlates with magnetic resonance imaging (MRI)-estimated VAT volume [10,11] and has stronger odds ratios for T2D and CVD vs. waist circumference (WC) [12]
The androidto-gynoid (A/G) ratio derived from Dual-energy x-ray absorptiometry (DXA) is valuable in assessing body fat distribution (BFD) and the prediction of VO [13]
Summary
Visceral adipose tissue (VAT) is a component of total body fat (TBF) responsible for high metabolic activity because it releases many bioactive hormones and molecules [1].Women with polycystic ovary syndrome (PCOS) are at risk for visceral obesity (VO) [2,3].PCOS is a complex, multifaceted disease linked with hyperandrogenism, hyperandrogenisation, oligoovulation, and polycystic ovarian morphology (PCOM) using ultrasound [4].About half of the patients diagnosed with PCOS are obese, according to the classical WorldHealth Organization (WHO)’s definition of body mass index (BMI) [5]. Visceral adipose tissue (VAT) is a component of total body fat (TBF) responsible for high metabolic activity because it releases many bioactive hormones and molecules [1]. Women with polycystic ovary syndrome (PCOS) are at risk for visceral obesity (VO) [2,3]. Abdominal obesity is a significant contributor to metabolic syndrome (MS) development, cardiovascular diseases (CVD, obesity-associated malignancies, type 2 diabetes (T2D), and fatty liver [7,8]. Faced with these risks, the need to determine the best intermediate predictor of VO in PCOS is essential
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