Visceral adiposity index is independently and positively related with impaired glucose regulation in women with polycystic ovary syndrome

Abstract

Objective To investigate whether the visceral adiposity content is associated with impaired glucose regulation (IGR), independent of insulin resistance and hyperandrogenism in women with polycystic ovary syndrome (PCOS). Methods A total of 401 PCOS patients [177 patients with normal glucose tolerance (NGT), 224 patients with IGR] and 200 healthy women matched with age, body mass index, waist circumference and waist to hip ratio in the Department of Endocrinology and Metabolism of Renji Hospital affiliated to Shanghai Jiaotong University School of Medicine from January 2015 to December 2017 were included. All subjects received 75 g oral glucose tolerance test. Insulin and sex hormone levels were measured by radioimmunoassay. Visceral adiposity content was determined by visceral adiposity index (VAI). Logistic regression was used to analyze the association between VAI and IGR. Results (1) The VAI level in PCOS patients with IGR group was higher than that in NGT group (3.7±2.6 vs 1.5±0.7, t=-11.019, P<0.05). (2) VAI was positively related with the homeostasis model assessment of insulin resistance (HOMA-IR), the glucose and insulin area under the curve (AUCglu and AUCins) (r=0.416, 0.542, 0.329, respectively, all P<0.05), but negatively related with the Matsuda index (r=-0.458, P<0.05). (3) The prevalence of IGR increased with VAI quartiles after adjustment for age, free androgen index and HOMA-IR in multivariate Logistic regression [the first quartile as a reference, the ORs of the second, third and fourth quartiles were 5.50 (95%CI: 1.15-10.47), 29.74(95%CI: 12.74-69.43) and 70.31(95%CI: 25.35-195.98), respectively; all P<0.05]. (4) The cut-off value of VAI in predicting the high risk of IGR was 1.94 (AUC=0.890, 95%CI: 0.858-0.922, sensitivity=0.826, specificity=0.853, P<0.05). Conclusions High visceral adiposity content is independently and positively related with high risk of IGR in PCOS patients. VAI>1.94 can predict the increased risk of IGR in PCOS women. Key words: Polycystic ovary syndrome; Insulin resistance; Visceral adiposity index; Impaired glucose regulation; Hyperandrogenism