According to trend analysis, with the increase of VAI quartiles, total T, E2, SHBG, follicle-stimulating hormone (FSH) and LH decreased (all P for trend <0.001) and as expected, waist, neck and hip circumference, BMI, other obesity indices, TG, low density lipoprotein (LDL) as well as prevalence of hypertension and diabetes increased (all P for trend <0.001). Here, PLOD1 is linked to obesity due to melanocortin 4 receptor deficiency.