title: Visceral adiposity index and DHEAS are useful markers of diabetes risk in women with polycystic ovary syndrome.
abstract: OBJECTIVE
  On the basis of the known diabetes risk in polycystic ovary syndrome (PCOS), recent guidelines of the Endocrine Society recommend the use of an oral glucose tolerance test (OGTT) to screen for impaired glucose tolerance (IGT) and type 2 diabetes (T2DM) in all women with PCOS. However, given the high prevalence of PCOS, OGTT would have a high cost-benefit ratio. In this study, we identified, through a receiver operating characteristic analysis, simple predictive markers of the composite endpoint (impaired fasting glucose (IFG) or IGT or IFG+IGT or T2DM) in women with PCOS according to the Rotterdam criteria.
  
  
  METHODS
  We conducted a cross-sectional study of 241 women with PCOS in a university hospital setting.
  
  
  METHODS
  Clinical, anthropometric, and metabolic (including OGTT) parameters were evaluated. The homeostasis model assessment of insulin resistance (HOMA2-IR), the Matsuda index of insulin sensitivity, and the oral dispositional index and visceral adiposity index (VAI) were determined.
  
  
  RESULTS
  Out of 241 women included in this study, 28 (11.6%) had an IFG, 13 (5.4%) had IGT, four (1.7%) had IFG+IGT, and four (1.7%) had T2DM. Among the anthropometric variables examined, the VAI had a significantly higher C-statistic compared with BMI (0.760 (95% CI: 0.70-0.81) vs 0.613 (95% CI: 0.54-0.67); P=0.014) and waist circumference (0.760 (95% CI: 0.70-0.81) vs 0.619 (95% CI: 0.55-0.68); P=0.028). Among all the hormonal and metabolic serum variables examined, DHEAS showed the highest C-statistic (0.720 (95% CI: 0.65-0.77); P<0.001).
  
  
  CONCLUSIONS
  In addition to fasting glucose, the VAI and DHEAS may be considered useful tools for prescreening in all women with PCOS without the classical risk factors for diabetes.
authors.affiliation: Biomedical Department of Internal and Specialist Medicine (Di.Bi.M.I.S.)Section of Cardio-Respiratory and Endocrine-Metabolic Diseases, University of Palermo, Piazza delle Cliniche 2, Palermo 90127, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Amato
authors.affiliation: Biomedical Department of Internal and Specialist Medicine (Di.Bi.M.I.S.)Section of Cardio-Respiratory and Endocrine-Metabolic Diseases, University of Palermo, Piazza delle Cliniche 2, Palermo 90127, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Magistro
authors.affiliation: Biomedical Department of Internal and Specialist Medicine (Di.Bi.M.I.S.)Section of Cardio-Respiratory and Endocrine-Metabolic Diseases, University of Palermo, Piazza delle Cliniche 2, Palermo 90127, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gambino
authors.affiliation: Biomedical Department of Internal and Specialist Medicine (Di.Bi.M.I.S.)Section of Cardio-Respiratory and Endocrine-Metabolic Diseases, University of Palermo, Piazza delle Cliniche 2, Palermo 90127, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Vesco
authors.affiliation: Biomedical Department of Internal and Specialist Medicine (Di.Bi.M.I.S.)Section of Cardio-Respiratory and Endocrine-Metabolic Diseases, University of Palermo, Piazza delle Cliniche 2, Palermo 90127, Italy carla.giordano@unipa.it.
authors.forename: C
authors.initials: C
authors.lastname: Giordano
mesh_terms: D050154:Adiposity / Q000502:physiology*; D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis* / Q000378:metabolism*; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000378:metabolism*; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis* / Q000378:metabolism*; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001786:Blood Glucose