Relationship between lipid accumulation product and new-onset diabetes in the Japanese population: a retrospective cohort study

Abstract

BackgroundDiabetes has become a global public health problem. Obesity has been established as a risk factor for diabetes. However, it remains unclear which of the obesity indicators (BMI, WC, WhtR, ABSI, BRI, LAP, VAI) is more appropriate for monitoring diabetes. Therefore, the objective of this investigation is to compare the strength of the association of these indicators and diabetes and reveal the relationship between LAP and diabetes.Methods15,252 people took part in this research. LAP was quartered and COX proportional risk model was applied to explore the relationship between LAP and new-onset diabetes. Smooth curve fitting was employed to investigate the non-linear link between LAP and diabetes mellitus. Finally, the receiver operating characteristic (ROC) curve was used to evaluate the predictive ability of the aforementioned indicators for diabetes.ResultsAfter adjusting for confounding factors, multiple linear regression analysis showed that each unit increase in LAP was associated with a 76.8% increase in the risk of developing diabetes (HR=1.768, 95% CI: 1.139 to 2.746, P=0.011). In addition, LAP predicted new-onset diabetes better than other indicators, and the AUC was the largest [HR: 0.713, 95% CI: 0.6806-0.7454, P<0.001, in women; HR: 0.7922, 95% CI: 0.7396-0.8447; P<0.001, in men]. When LAP was used as a lone predictor, its AUC area was largest both men and women. However, after adding classical predictors (FPG, HbA1c, SBP, exercise, age) to the model, the LAP is better than the ABSI, but not better than the other indicators when compared in pairs.ConclusionsHigh levels of LAP correlate very strongly with diabetes and are an important risk factor for diabetes, especially in women, those with fatty liver and current smokers. LAP was superior to other indicators when screening for diabetes susceptibility using a single indicator of obesity, both in men and in women. However, when obesity indicators were added to the model together with classical predictors, LAP did not show a significant advantage over other indicators, except ABSI.

Association of lipid accumulation product and the risk of type 2 diabetes; a cross sectional population-based study

“…Visceral adiposity index (VAI) and waist/height ratio (WHtR) [20,40]. Similarly, the present study also showed that LAP (AUC = 0.66) has higher diagnostic value than WC (AUC = 0.60) and TG (AUC = 0.64).…”

“…The association between LAP and T2DM has been found to be positive in several demographic and ethnic subgroups. Brie y, in the Japanese population, high LAP have been shown to increase the risk of T2DM by 76% over time [20]. Similar results have been reported in adults Chinese and middle-aged Koreans [27,28].…”

“…LAP is a combined index of WC and TG levels, used to assess visceral fat. Research conducted in some populations suggests that the LAP index is a reliable predictor for chronic conditions such as metabolic syndrome, CVD, hypertension, and T2DM [17][18][19][20]. It appears that there has not been a thorough study in Iran to examine the effectiveness of LAP in predicting T2DM.…”

Association of adiposity indicators with cardiometabolic multimorbidity risk in hypertensive patients: a large cross-sectional study

“…LAP has emerged as a promising anthropometric index for assessing cardiometabolic risk ( 31 , 34 ). Evidence showed that LAP serves as a predictor of diabetes risk in both Japanese and Chinese populations, outperforming traditional obesity indicators ( 35 , 36 ). A population-based prospective cohort study conducted in China revealed that individuals in the high LAP group had a 1.67 times higher risk of stroke compared to those in the low LAP group ( 37 ).…”