Association and Interaction Analysis of Lipid Accumulation Product with Impaired Fasting Glucose Risk: A Cross-Sectional Survey

Abstract

Aims Lipid accumulation product (LAP) is put forward as a powerful marker showing the accumulation of visceral fat. The present study is aimed at (i) analyzing the predictive performances of LAP in the identification of impaired fasting glucose (IFG) in Chinese population and (ii) exploring the potentially interactive effect between LAP and other factors on IFG risk. Methods Analysis was conducted on the data obtained from a community-based cross-sectional survey in Chinese population, and all the participants enrolled were required to complete a face-to-face questionnaire survey and related health checks. Then, for the purpose of comparing predictive values between LAP and conventional obesity indices for IFG, relevant analysis was carried out on the receiver operating characteristic (ROC) curve. The assessment of interactive effects was conducted by employing the three indicators as follows: (1) RERI (the relative excess risk due to interaction), (2) AP (attributable proportion due to interaction), and (3) SI (synergy index). Results A total of 1777 participants (748 males and 1029 females) were involved in the final analysis. It was finally obtained that the prevalence rate of IFG was 14.1% in total, 15.5% for males and 13.1% for females, respectively. In logistic regression analysis, individuals with LAP levels in the fourth quartile had a significant higher risk of getting IFG in comparison with that of the lowest quartile (crude OR: 4.58, 95% CI: 3.01-6.98; adjusted OR: 3.81, 95% CI: 2.33-6.23). In addition, it was indicated by the ROC curve analysis that LAP showed a better performance in discriminating IFG risk than BMI in both males (Z = 2.20, P = 0.028) and females (Z = 2.13, P = 0.033). However, LAP displayed a higher predictability in comparison with WC only in females (Z = 2.07, P = 0.038), but not in males (Z = 0.18, P = 0.860). Furthermore, LAP and family history of diabetes were able to impose significant synergistic interaction on the risk of IFG, which was indicated by all the parameters in females (RERI: 2.52, 95% CI: 0.19-4.84; AP: 0.47, 95% CI: 0.20-0.74; SI: 2.39, 95% CI: 1.17-4.87) and males (RERI: 2.18, 95% CI: 0.08-4.73; AP: 0.43, 95% CI: 0.07-0.79; SI: 2.15, 95% CI: 1.03-5.45). However, none of the indicators showed significant interaction between LAP and smoking on the risk of IFG in females (RERI: 0.92, 95% CI: -2.79-4.63; AP: 0.20, 95% CI: -0.50-0.92; SI: 1.37, 95% CI: 0.42-4.52). Meanwhile, there was also no significant interaction between LAP and smoking on the risk of IFG in males as indicated by the value of SI (2.22, 95% CI: 0.80-6.21). Conclusion It was concluded that LAP was significantly related to a higher risk of IFG in Chinese population, and its performance was superior to that of conventional obesity indices, especially in females. Apart from that, LAP with family history of diabetes may have an interactive effect that can impose a great influence on the development of IFG.

Interaction Analysis of Lipid Accumulation Product and Family History of Diabetes on Impaired Fasting Glucose and Diabetes Risk in Population with Normotension in Eastern China: A Community-based Cross-sectional Survey

“…However, no signi cant interaction between LAP and general obesity was observed in study population. Previous studies have explored the interaction effect between LAP and abdominal obesity on risk of diabetes [48,55], but our result seem to be inconsistent.…”

“…The prevalence of IFG and diabetes gradually increased across LAP quartiles, the values in the fourth quartile of LAP were dramatically higher than in the rst quartile (12.6% vs. 5.9%, 20.8% vs. 8.9%, respectively), and this conclusion was consistent with other similar studies in China. A cross-sectional study in Beijing showed that an elevated level of LAP was closely linked to an increased risk of diabetes in elderly people [47], and a survey in Anhui province con rmed that there is a positive correlation between LAP and IFG [48].…”

Lipid Accumulation Product is Associated with Urinary Albumin-creatinine Ratio in Chinese Prediabitic Population: A Report from the REACTION Study

“…LAP presented as a surrogate marker of visceral adiposity, was reportedly a powerful predictor of prediabetes and CKD, respectively. 9 , 16 , 17 A prospective study in Europe enrolled 148 women with polycystic ovary syndrome proved that elevated LAP was associated with prediabetes. 18 Another community-based cross-sectional survey involving 1777 Chinese participants indicated that LAP showed a better performance in discriminating IFG risk than BMI.…”

Hypertriglyceridemic Waist Phenotype and Lipid Accumulation Product: Two Comprehensive Obese Indicators of Waist Circumference and Triglyceride to Predict Type 2 Diabetes Mellitus in Chinese Population

“…LAP is calculated from WC and fasting TG levels, which has a theoretical basis in reflecting the accumulation of visceral fat [ 19 ]. Several studies indicated that LAP displayed a better predictive ability in metabolic syndrome, diabetes, and impaired fasting glucose as compared with common obesity indices [ 20 – 22 ]. But some studies indicated that high LAP was not associated with an increased risk of T2DM [ 41 ], and LAP may not be an inexpensive tool for predicting T2DM [ 42 ].…”

“…The second is lipid accumulation product (LAP), calculated from WC and fasting TG levels, which was first proposed to recognize cardiovascular risk in 2005 [ 19 ]. Several studies indicated that LAP displayed a better predictive ability in metabolic syndrome, diabetes, and impaired fasting glucose as compared with common obesity indices [ 20 – 22 ]. Many studies have indicated that metabolic syndrome and its components were risk factors for T2DM [ 23 , 24 ].…”