Lipid accumulation product: a powerful marker of metabolic syndrome in healthy population

Abstract

Objective: The metabolic syndrome (MS) is a cluster of cardiometabolic factors, which predisposes to diabetes and cardiovascular disease (CVD). Early detection of high-risk individuals for MS using accurate measures of insulin resistance (IR) could improve detection and prevention of CVD and diabetes. The aim of this study was to explore the ability of lipid accumulation product (LAP), compared with traditional measures of IR, to identify MS. Design: In total, 768 Spanish adults were recruited. MS was assessed using the revised criteria of National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) and International Diabetes Federation (IDF). Measures of IR such as homeostasis model assessment of IR and LAP, an index of lipid accumulation based on a combination of waist circumference and serum triglycerides, were calculated. Receiver operating characteristic analysis was performed in order to detect the parameter with the best predictive capability for MS. Results: The prevalence of MS-NCEP/ATP III and MS-IDF was 15.1 and 20.5% for men respectively, and 15.4 and 17.5% for women. LAP showed the highest diagnostic accuracy for MS-NCEP/ATP III (area under the curve 0.91 and 0.90 among males and females) and MS-IDF (0.88 for both males and females). This was confirmed by internal validation using 20 000 bootstrap samples. Among males and females, different LAP cut-off values exhibited high sensitivity (78-85%) and specificity (78-85%) for MS-NCEP/ATP III and MS-IDF identification with elevated efficiency (proportion of positives and negatives classified correctly by the testZ78-85%). When the sample was stratified according to decades of life, LAP exhibited a slightly lower performance among women than men, especially for MS-IDF detection. Conclusions: In non-diabetic adults LAP has a strong and reliable diagnostic accuracy for MS-IDF and, especially, MS-NCEP/ATP III among females and, in particular, among males from Spain.

Lipid accumulation product is a powerful index for recognizing insulin resistance in non-diabetic individuals

“…23 Therefore, increased LAP may indicate ectopic lipid deposition and reflect lipid overaccumulation. 12,14 It suggested that in both the cross-sectional study and the prospective study, LAP was an effective index for assessing the risk of CVD and diabetes. Previous studies found that LAP outperformed BMI and WC in identifying metabolic disease.…”

“…LAP was closely associated with CVD, diabetes and metabolic syndrome and outperformed BMI for identifying these diseases. 8,[12][13][14] In polycystic ovary syndrome patients, LAP was an effective index with higher sensitivity and specificity than BMI and WC for predicting CVD. 13 Although there were some studies on the correlation between LAP and CVD, diabetes in European subjects, there have been few studies looking at the correlation between LAP and IR in Asian cohort.…”

Predictors of Metabolic Syndrome in the Elderly: A Review

“…3 Most of the studies analysed evaluated a mixed population, stratified by sex and/or age range. The cut-off point for LAP suggested by the authors [22][23][24][25][26] varied from 31.6 to 51.8, with a difference between the sexes (Table 4). Among men, the LAP AUC to predict MetS varied from 0.84 to 0.937, while for women the lowest AUC was 0.78 and highest was 0.904 (Table 4).…”

Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI) a Simple and Clinically Useful Surrogate Marker for Metabolic Syndrome and Cardiovascular Disease Predictor in Non-diabetic Venezuelan Adults

“…An assay published by Taverna et al [39] in healthy Argentine males, LAP showed an area under the highest curve even than other IR variables, such as HOMA-IR and QUICKI, whereby LAP has been associated with lipolysis of visceral compartment, which is considered by De Fronzo to be the beginning of the cascade of changes that characterize the pathophysiology of IR [40]. By evaluating individually, the components of the MetS, the VAI and LAP indexes were correlated with better precision with the value of WC and triglycerides; To measure the risk of MetS (Figure 3, Figure 4, Figure 5 and Figure 6).…”

“…Although explanations for this observation have not yet been elucidated, it is likely to be related to differences in the regional distribution of adipose tissue by sex as well as patterns of visceral fat deposition. In addition, in fact, men have, on average, more visceral fat and less subcutaneous fat [39]. In our results, the LAP index was the parameter with the highest sensitivity discriminating individuals with and without MetS in the ROC curve, with AUC 0.9489 ( Figure 7 and Figure 8), which is consistent with several population studies conducted in individuals from China [41,42] and Iran, which showed the same conclusions [29], similarly to Abruzzese et al [43] in a population of Latin America, found similar results, with similar cutoff points for different populations and ethnic groups.…”