Visceral Adiposity Index as an Indicator for Menstrual Disturbance, Hormonal and Metabolic Dysfunction in Polycystic Ovarian Syndrome

Background: Increase in visceral adiposity is characteristic of polycystic ovarian syndrome (PCOS) and is the main cause of insulin resistance and hyperandrogenism. This study tried to compare the visceral adiposity index (VAI) in PCOS women and control population, thereby exploring its correlation with ovarian morphology, hormonal and metabolic dysfunction. Materials and Methods: Reproductive-age women who fulfilled the Rotterdam criteria for PCOS constituted the cases. Control population consisted of the same number of non-PCOS women. History of menstrual irregularity and features of hyperandrogenism were noted. Overnight fasting serum hormonal profile on second day of the cycle, oral glucose tolerance test (OGTT) and serum fasting insulin and lipid profile were obtained. Ultrasound evaluation was done simultaneously. Free androgen index (FAI), homeostatic model assessment of insulin resistance (HOMA-IR) and VAI were calculated. Results: Serum androgen levels and OGTT were greater in PCOS women. No significant difference was noted in serum fasting glucose, fasting insulin and lipid profile between cases and controls. Both systolic and diastolic blood pressures were significantly higher among women with PCOS. Mean ovarian volume, antral follicle count, FAI and HOMA-IR were higher in PCOS women. VAI was significantly higher in cases compared to controls. VAI demonstrated a strong negative correlation with number of menstrual cycles per year. Increasing VAI was associated with longer menstrual cycles and correlated positively with greater severity of anovulation. VAI also showed highly significant correlation with fasting blood glucose and statistically significant moderately strong positive correlation with OGTT values at two hours post glucose challenge, systolic blood pressure and mean ovarian volume. There was no demonstrable correlation between androgen levels or HOMA-IR values. Conclusion: VAI is higher in women with PCOS. It correlates positively with features of disease severity and ovarian morphology. An assessment of VAI in PCOS women could be predictive of a greater propensity for development of classical metabolic risk factors.