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

Abstract

Background Lipid accumulation product (LAP) is considered to be a new convenient useful indicator to assess the visceral fat. Therefore, we aimed to evaluate the risk factors of impaired fasting glucose (IFG) and diabetes, and explore the possible interacting influences of LAP with other factors on the risk of IFG and diabetes among Chinese normotension adults. Methods A multistage stratified cluster sampling method was conducted to select urban residents in Bengbu, China. For each eligible participant, data on questionnaire survey, anthropometric measurements and laboratory tests were obtained. The effects of body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR) and LAP for predicting IFG and diabetes were performed by multiple logistic regressions and receiver operating characteristic (ROC) analyses. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). Results Six thousand, four hundred sixty-seven normotension subjects (2695 men and 3772 women) were enrolled in our study, the prevalence of IFG and diabetes were 9.37% and 14.33%, respectively. When assessed using ROC curve analysis, LAP exhibited higher diagnostic accuracy for identifying IFG and diabetes than BMI, the area under the AUC curve was 0.650 (95% CI: 0.637 to 0.662). After adjustment for age, sex, educational level and other confounding factors, multivariate logistic regression analyses indicated that subjects with the fourth quartile of LAP were more likely to develop IFG (adjusted OR: 2.735, 95% CI: 1.794–4.170) and diabetes (adjusted OR: 1.815, 95% CI: 1.297–2.541) than those with the first quartile. A significant interaction between LAP and family history of diabetes was observed in participants (RERI = 1.538, 95%CI: 0.167 to 3.612; AP = 0.375, 95%CI: 0.118 to 0.631; SI = 1.980, 95%CI: 1.206 to 3.251). However, a significant interaction between LAP and abdominal obesity was indicated by the value of RERI (1.492, 95%CI: 0.087 to 3.723) and AP (0.413, 95%CI: 0.014 to 0.756), but not the value of SI (1.824, 95%CI: 0.873 to 3.526). Conclusion Our results demonstrated that there might be synergistic effect between LAP and family history of diabetes on the risk of IFG and diabetes.

The predictive significance of lipid accumulation products for future diabetes in a non-diabetic population from a gender perspective: an analysis using time-dependent receiver operating characteristics

“…Subsequently, more studies have explored the relationship between LAP and diabetes. Overall, there is a positive correlation between LAP and diabetes risk ( 24 – 35 , 52 – 61 ), and LAP has been found to be effective in diagnosing/predicting diabetes ( 24 – 31 , 56 – 62 ). However, further differentiation between genders in the studies revealed some interesting trends, with two studies ( 26 , 27 ) showing stronger associations of LAP with diabetes in males than in females; furthermore, in a study involving the general Indonesian population ( 63 ), the cross-sectional analysis showed that LAP was associated with diabetes risk in females, while this association disappeared in the male population, and in a subsequent study of 2,427 baseline non-diabetic participants with 4-year follow-up period, LAP was not associated with the risk of future diabetes in either gender.…”

The value of lipid accumulation products in predicting type 2 diabetes mellitus: a cross-sectional study on elderlies over 65 in Shanghai

“…The CUT-off value of this study was 33.8 (sensitivity, 72%; specificity, 44%) in the study population, and the AUC was 0.613, which is similar to results of a couple of studies. Shu et al (2022) reported a cut-off value of 33.54 with an AUC of 0.650 (sensitivity, 54.6%; specificity, 62.42%) [ 26 ]. This study was conducted in Bengbu, Anhui Province of Eastern China.…”