Variation of Adipokines in Obese versus Non Obese Patients with Polycystic Ovary Syndrome and its Association to Visceral Adiposity Index: A Cross-sectional Study

Abstract

Introduction: Obesity is a prevalent co-morbidity in Polycystic Ovarian Syndrome (PCOS), causing metabolic disturbances that lead to changes in endocrinological homeostasis. Adipokines are proinflammatory molecules secreted by adipose tissues that affect metabolic and endocrinological mechanisms. Excess androgen secretion alters fat distribution and deposition, leading to increased visceral obesity in PCOS, which is a major concern for the development of cardiometabolic events. Aim: To assess the Visceral Adiposity Index (VAI) and levels of different adipokines in non obese and obese PCOS patients, and to establish the relationship between VAI and circulating adipokines in both non obese and obese phenotypes of PCOS patients. Materials and Methods: This cross-sectional study was conducted at the Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh, India from November 2019 to August 2021. A total of 144 patients diagnosed with PCOS according to the Rotterdam criteria were divided into non obese and obese categories based on Body Mass Index (BMI). VAI was calculated using a sex-specific formula, and serum levels of adiponectin, resistin, and leptin were measured by Enzyme Linked Immuno Sorbent Assay (ELISA). Fasting glucose, insulin, and serum lipid profiles were evaluated. Data were statistically analysed using Student’s t-tests and Pearson’s correlation coefficient. Weighted linear regression was used to detect any relationships between adipokines, obesity indicators, and VAI. Results: A total of 144 female patients with a mean age of 27.47±0.33 years suffering from PCOS were included in this study. VAI was significantly higher (p-value=0.034) in non obese patients than in obese patients. There was a significant correlation between VAI and resistin (r-value=0.302, p-value=0.011) and leptin (r-value=0.308, p-value=0.009) in the non obese PCOS group. Additionally, there was a significant association between obesity indicators {BMI, Body Fat Percentage (BFP), Waist Circumference (WC), and Hip Circumference (HC)} and VAI; this association was absent in the obese subgroup. According to the regression model, leptin was the only statistically relevant predictor for VAI among the studied PCOS patients (t-value=2.278, p-value=0.024). Conclusion: VAI was higher in non obese PCOS patients. An imbalance in adipokines (leptin and resistin) may lead to the accumulation of visceral fat without significantly affecting BMI.

Keywords

• adiponectin
• high density lipoprotein cholesterol
• leptin
• resistin
• triglyceride
• visceral fat