Visceral Adiposity Index (VAI) Levels in Patients with Different Phenotypes of Polycystic Ovary Syndrome (PCOS)

Background and Objectives: We aimed to compare visceral adiposity index (VAI) levels among polycystic ovary syndrome (PCOS) subtypes in this study. Matherials and Methods: A total of 180 PCOS patients and 51 controls were included. Patients were divided into the following subtypes: Phenotype A (n=96), clinical and/or biochemical hyperandrogenism (HA)+oligo-anovulation (OA)+polycystic ovarian morphology (PCOM); Phenotype B (n=19), HA+OA; Phenotype C (n=35), HA+PCOM; and, Phenotype D (n=30), OA+PCOM. VAI was calculated for women by the following formula: (Waist circumference/[36.58+(1.89xBody mass index)])x[(triglyceride(mmol/L)/0.81)x(1.52xHigh density lipoprotein-cholesterol(mmol/L))]. Results: In the total PCOS patients, VAI levels were higher than controls [1.21 (0.39-10.89) and 0.85 (0.32-1.87), respectively] (p< 0.001). VAI levels were higher in Phenotype A [1.46 (0.39-10.89)] and Phenotype B [1.31 (0.43-4.39)] than in controls [0.85 (0.32-1.87)], and also higher in Phenotype A than in Phenotype C [1.00 (0.41-4.79)] and Phenotype D [1.01 (0.4-3.21)] (p=0.003 and p=0.001, respectively). While present in 38 patients (21.1%) in the PCOS group, there was no metabolic syndrome (MetS) in controls (p< 0.001). In Phenotypes A, B, and D, while more patients had MetS than controls (p< 0.001, 0.004, and 0.021, respectively), more patients had MetS in Phenotype A, compared to Phenotypes C and D (p=0.003 and p=0.021, respectively). Given ROC analysis, the VAI cut-off value in predicting MetS in the PCOS group was 1.66 (sensitivity: 94.74% and specificity: 83.1%). Conclusions: PCOS phenotypes characterized by HA and OA, particularly Phenotypes A and B, are associated with higher VAI values and an increased frequency of MetS, underscoring the importance of early metabolic assessment in these patient groups.