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Comparative performance of traditional and novel adiposity indices for predicting insulin resistance and metabolic syndrome in Chinese women with polycystic ovary syndrome

Qin H, Shi B, Li Y, Lu F, Guan M, Yu J, Gao Z, Zhu M et al.

Frontiers in nutrition, 2026

944 participants

Abstract

Objective: This study aimed to comprehensively evaluate and compare the predictive performance of seven adiposity indices-both traditional (waist-to-hip ratio, WHR; waist-to-height ratio, WHtR) and novel (visceral adiposity index, VAI; Chinese visceral adiposity index, CVAI; lipid accumulation product, LAP; triglyceride-glucose index, TyG; cardiometabolic index, CMI)-for identifying insulin resistance (IR) and metabolic syndrome (MetS) in a large cohort of Chinese women with polycystic ovary syndrome (PCOS).

Methods: This secondary analysis enrolled 944 Chinese women with PCOS from the PCOSAct trial. IR was defined as homeostasis model assessment of insulin resistance (HOMA-IR) ≥ 2.69, and MetS was diagnosed in accordance with Chinese female-specific criteria. Receiver operating characteristic (ROC) curve analysis was applied to assess the discriminatory ability of each adiposity index, and correlations between these indices and metabolic, reproductive, hepatic as well as renal parameters were analyzed.

Results: The prevalence of IR and MetS in this cohort was 50 and 15.68%, respectively. All adiposity indices were significantly correlated with key metabolic parameters (all p < 0.001). For predicting IR, LAP (AUC = 0.815) and CVAI (AUC = 0.813) showed the highest diagnostic accuracy. For predicting MetS, CMI (AUC = 0.905), LAP (AUC = 0.898) and VAI (AUC = 0.893) presented the optimal predictive efficacy. Additionally, these adiposity indices were significantly correlated…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 944 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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