DEXA-Derived Body Fat Distribution and Its Correlation With Clinical, Anthropometric, Insulin Sensitivity, Metabolic, and Hormonal Parameters Among Kashmiri Polyendocrine Metabolic Ovarian Syndrome (PMOS) Women: A Cross-Sectional Study.

BACKGROUND: Polyendocrine metabolic ovarian syndrome (PMOS) is a common endocrine and metabolic disorder affecting women of reproductive age. It is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology (PCOM) and is commonly associated with obesity, particularly central adiposity, which is linked to metabolic and hormonal derangements. Dual-energy X-ray absorptiometry (DEXA) enables the precise assessment of regional body fat distribution, overcoming the limitations of conventional anthropometric indices, which inadequately characterize fat distribution. OBJECTIVES: This study aimed to assess the body fat distribution among Kashmiri women with PMOS using DEXA (GE Lunar densitometer, GE HealthCare, Chicago, IL, USA) and further evaluate its correlation with anthropometric, metabolic, insulin sensitivity, and hormonal parameters. METHODS: This cross-sectional study included 157 women aged 18-45 years diagnosed with PMOS according to the Rotterdam criteria. Whole-body DEXA was used to assess total, android, trunk, gynoid, arm, and leg fat in PMOS women. Pearson's correlation analysis was employed to examine associations of regional fat depots with anthropometric, metabolic, insulin sensitivity, and hormonal variables. RESULTS: The mean age of PMOS patients was 22.83±2.82 years, with a mean body mass index (BMI) of 24.86±3.84 kg/m² and a mean waist-to-hip ratio (WHR) of 0.94±0.06. The mean total body fat percentage was 36.65±6.78%, with relatively higher proportions of android fat (42.9±9.41%) and trunk fat (40.58±7.70%) compared to peripheral depots. Android fat presented robust significant positive correlations with BMI (r=0.697), fasting insulin (r=0.65), Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) (r=0.55), and WHR (r=0.497), while weak correlation was observed with cholesterol (r=0.285), triglycerides (r=0.285), two-hour glucose (r=0.235), and Ferriman-Gallwey Score (FGS) (r=0.264) (all p<0.01). Trunk fat depicted a high correlation with fasting insulin (r=0.77), HOMA-IR (r=0.62), BMI (r=0.725), and WHR (r=0.486), while a weak correlation was observed with triglycerides (r=0.297), cholesterol (r=0.293), two-hour glucose (r=0.207), and FGS (r=0.263). Gynoid, arm, and leg fat demonstrated a strong and significant correlation mainly with anthropometric parameters. CONCLUSION: Women with PMOS had greater proportions of android and trunk fat, according to DEXA analysis. Also, DEXA-based fat distribution indicated significant correlation with insulin sensitivity, anthropometric, metabolic, and clinical hyperandrogenism parameters, whereas no substantial correlation patterns were observed with the hormonal variables evaluated in this study.