#234 : Impact of Visceral Adiposity Index on the Pregnancy Outcomes of Women with Polycystic Ovary Syndrome

Abstract

Background and Aims: Despite the widely used of body mass index (BMI) to indicate body fatness, it does not take into account muscle mass, bone density, overall body composition, and racial and sex differences. Visceral adiposity index (VAI) is an empirical-mathematical model gender-specific to indicate fat distribution and function. VAI was calculated based on simple anthropometry and metabolic parameters. There may be a correlation between VAI and reproductive outcomes. This study investigates the correlation between VAI and pregnancy outcomes in PCOS women. Method: This prospective cohort study was conducted at IVFMD, My Duc Hospital, from June 2020 to August 2022. This study included infertile PCOS women aged between 18 and 40 years. At the initial workup, PCOS women were evaluated for their VAI. We then classified them into four groups based on their VAI: <1.5, 1.5-<3.0, 3.0-<4.5, and ≥4.5. We continued to follow their reproductive outcomes for up to 12 months since the initial evaluation. The primary outcome was the pregnancy rate 12 months after the first workup. Secondary outcomes were insulin resistance, impaired fasting glucose (IFG), impaired glucose tolerance (IGT), pre-diabetes, and type 2 diabetes mellitus (T2DM). Results: A total of 1,200 PCOS women were included in this study; of which, only 794 patients had complete data after 12-month follow-up. The mean age of patients was 29.2 ± 3.7 years. Mean BMI was 23.0 ± 4.0 kg/m2. Median VAI was 2.1 [1.3; 3.8]. Ongoing pregnancy rate was significantly lower in groups of women with higher VAI (47.9% in group with VAI of <1.5, 40.2% in 1.5-<3.0, 38.5% in 3.0-<4.5, and 33.9% in ≥4.5, respectively, P = 0.04). In addition, insulin resistance, IFG, IGT, and T2DM were found to be higher with increased VAI except for pre-diabetes. Conclusion: VAI has a negative impact on ongoing pregnancy and is associated with an increased risk of glucose metabolic abnormalities in infertile women with PCOS. Clinicians may use VAI as a predictor of pregnancy outcomes and GDM to advise these patients on their pregnancy care.