Visceral adiposity index and lipid accumulation product index: The promising role in assessing cardiometabolic risk in non-obese patients of PCOS

BACKGROUND: The combination of metabolic disorders like obesity, insulin resistance, reduced glucose tolerance, diabetes mellitus, and dyslipidemia poses an increased risk of cardiovascular events in patients with PCOS which is closely related to increased visceral fat accumulation. This study explored the noninvasive adiposity markers like Visceral Adiposity Index (VAI) and Lipid Accumulation Product (LAP) levels in non-obese PCOS patients and their associations with clinico-metabolic parameters. METHODS AND MATERIALS: The case-control study was conducted with a total of 66 PCOS cases and 40 healthy controls (aged 18-35). Their lipid profile, fasting insulin levels and homeostatic model of insulin resistance index, VAI, and LAP scores were estimated. The cases were divided into three groups depending on the presence of cardiovascular risk factors. The predictive power of LAP and VAI with respect to cardiovascular outcomes was assessed by ROC curves. RESULTS: The VAI and LAP scores have shown a significant positive correlation with markers of metabolic syndrome. When multiple risk factors are considered simultaneously, the cutoff value of VAI is 2.59 with 91% sensitivity and 80% specificity, and that of the LAP score is 40.2 with 91% sensitivity and 83% specificity. The area under curves for VAI was 0.935 and for LAP was 0.945 considering the presence of at least three risk factors. CONCLUSION: The study concluded that with a definitive cutoff value, VAI and LAP were inexpensive, simple, and effective screening tools for cardiometabolic risk assessment in non-obese women with PCOS and can be an effective way to determine long-term cardiovascular outcomes and prevent them.