Abstract
BackgroundTo compare the efficacy of lipid accumulation product (LAP) and urine glucose excretion (UGE) in predicting diabetes and evaluate whether the combination of LAP and UGE would help to improve the efficacy of using LAP alone or UGE alone in identifying diabetes.MethodsData from 7485 individuals without prior history of diabetes who participated in a cross-sectional survey in Jiangsu, China, were analyzed. Each participant underwent an oral glucose-tolerance test. Operating characteristic curves (ROC) and logistic regression analyses were used to evaluate the performance of LAP and UGE in identification of newly diagnosed diabetes (NDM) and prediabetes (PDM).ResultsFor subjects with NDM, the area under the ROC curve was 0.72 for LAP and 0.85 for UGE, whereas for PDM, these values were 0.62 and 0.61, respectively. Furthermore, LAP exhibited a comparable sensitivity with UGE in detecting NDM (76.4% vs 76.2%, p = 0.31). In predicting PDM, LAP showed a higher sensitivity than UGE (66.4% vs 42.8%, p < 0.05). The combination of LAP and UGE demonstrated a significantly higher sensitivity than that of LAP alone and UGE alone for identification of NDM (93.6%) and PDM (80.1%). Moreover, individuals with both high LAP and high UGE had significantly increased risk of NDM and PDM than those with both low LAP and low UGE.ConclusionsThe combination of LAP and UGE substantially improved the efficacy of using LAP and using UGE alone in detecting diabetes, and may be a novel approach for mass screening in the general population.
Highlights
There are evidences that a variety of physiological aberrations caused by obesity mainly depend on the distribution of body fat, instead of overweight or obesity per se [1, 2]
Individuals with NDM and PDM were older, had higher blood pressure (BP), fasting plasma glucose (FPG), 2 h plasma glucose (2h-PG), total cholesterol (TC), TG, and showed a greater body mass index (BMI), compared with normal glucose tolerance (NGT) subjects, while there was no difference in creatinine levels
Further analysis showed that individuals with H-urine glucose excretion (UGE)/ H-Lipid accumulation product (LAP) displayed higher risk of NDM (OR = 36.70, 95% CI: 25.28 - 53.30) than those with low UGE (L-UGE)/high LAP (H-LAP) (OR = 2.08, 95% CI: FIGURE 2 | Logistic regression analyses of odds ratios for newly diagnosed diabetes (NDM) with adjustment of age, genders, blood pressure, total cholesterol, body mass index, blood urea nitrogen, and creatinine
Summary
There are evidences that a variety of physiological aberrations caused by obesity mainly depend on the distribution of body fat, instead of overweight or obesity per se [1, 2]. Computed tomography (CT) or magnetic resonance imaging is considered as the gold standard for assessing lipid accumulation and distribution patterns. They cannot be widely applied in clinical practice since they are costly and time-consuming. In addition to the simple calculation, LAP does not require high expenditure of time and cost, making it suitable for a large sample population. Accumulation of visceral fat measured by CT over 5 years is independently associated with greater risk of incident diabetes [6]. To compare the efficacy of lipid accumulation product (LAP) and urine glucose excretion (UGE) in predicting diabetes and evaluate whether the combination of LAP and UGE would help to improve the efficacy of using LAP alone or UGE alone in identifying diabetes
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