The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison

Abstract

BackgroundBody mass index (BMI, kg/m2) may not be the best marker for estimating the risk of obesity-related disease. Consistent with physiologic observations, an alternative index uses waist circumference (WC) and fasting triglycerides (TG) concentration to describe lipid overaccumulation.MethodsThe WC (estimated population minimum 65 cm for men and 58 cm for women) and TG concentration from the third National Health and Nutrition Examination Survey (N = 9,180, statistically weighted to represent 100.05 million US adults) were used to compute a "lipid accumulation product" [LAP = (WC-65) × TG for men and (WC-58) × TG for women] and to describe the population distribution of LAP. LAP and BMI were compared as categorical variables and as log-transformed continuous variables for their ability to identify adverse levels of 11 cardiovascular risk factors.ResultsNearly half of the represented population was discordant for their quartile assignments to LAP and BMI. When 23.54 million with ordinal LAP quartile > BMI quartile were compared with 25.36 million with ordinal BMI quartile > LAP quartile (regression models adjusted for race-ethnicity and sex) the former had more adverse risk levels than the latter (p < 0.002) for seven lipid variables, uric acid concentration, heart rate, systolic and diastolic blood pressure. Further adjustment for age did not materially alter these comparisons except for blood pressures (p > 0.1). As continuous variables, LAP provided a consistently more adverse beta coefficient (slope) than BMI for nine cardiovascular risk variables (p < 0.01), but not for blood pressures (p > 0.2).ConclusionLAP (describing lipid overaccumulation) performed better than BMI (describing weight overaccumulation) for identifying US adults at cardiovascular risk. Compared to BMI, LAP might better predict the incidence of cardiovascular disease, but this hypothesis needs prospective testing.

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

“…Second, the reliability of our findings was confirmed by internal validation using bootstrapping, a powerful statistical procedure (13). Third, LAP is simple, inexpensive, and easy to calculate (3,4), and could be a useful obesity estimator where height and/or weight may be difficult to assess (for example, amputees). Fourth, LAP showed a good efficiency to identify MS independently of the classification used to detect it (using either NCEP/ATP III or IDF criteria), although its ability was slightly lower for MS-IDF identification, especially among women.…”

“…(TG concentration (mmol/l)) for men, and (WC (cm)K58)! (TG concentration (mmol/l)) for women (3). LAP was created to describe the extent to which a subject had traveled the route of both increasing waist and TG.…”

Lipid Accumulation Product is Related to Metabolic Syndrome in Women with Polycystic Ovary Syndrome

“…Insulin sensitivity was assessed by homeostasis model assessment of insulin resistance (HOMA-IR), HOMA-IR = FBG (mmol/L) × FINS (mIU/L)/22.5. LAP was calculated using the formula [waist (cm) − 58] × triglyceride concentration (mmol/l), as previously reported [ 10 ] .…”

Avaliação do risco cardiovascular por meio do índice LAP em pacientes não obesas com síndrome dos ovários policísticos

“…É importante destacar que o índice LAP representa um importante indicador não só de risco cardiovascular (18,19), mas também de RI (19), diabetes tipo 2 (26) e mortalidade (27). Dentro dessa perspectiva, por meio da combinação de duas medidas simples e de baixo custo (circunferência da cintura e concentração plasmática de triglicerídeos), o índice LAP pode ser utilizado na prática clínica para avaliar e monitorar o risco cardiovascular de mulheres jovens com SOP.…”

“…Sua determinação em mulheres é dada pela seguinte equação: (circunferência da cintura [cm] -58) x (triglicerídeos [mmol/L]) (18). Além da facilidade para mensuração e do baixo custo, o índice LAP tem se destacado como importante indicador de risco cardiovascular em mulheres (18), inclusive com SOP (19).…”