The "lipid accumulation product" is associated with 2-hour postload glucose outcomes in overweight/obese subjects with nondiabetic fasting glucose.

Alexis Elias Malavazos,Federica Ermetici,Silvia Briganti,Mariangela Rondanelli,Lelio Morricone,Riccardo Caccialanza,Emanuele Cereda

doi:10.1155/2015/836941

Abstract

“Lipid accumulation product” (LAP) is a continuous variable based on waist circumference and triglyceride concentration previously associated with insulin resistance. We investigated the accuracy of LAP in identifying oral glucose tolerance test (OGTT) abnormalities and compared it to the homeostasis model assessment of insulin resistance (HOMA-IR) in a population of overweight/obese outpatients presenting with nondiabetic fasting glucose. We studied 381 (male: 23%) adult (age: 18–70 years) overweight/obese Caucasians (body mass index: 36.9 ± 5.4 Kg/m2) having fasting plasma glucose < 7.0 mmol/L. OGTT was used to diagnose unknown glucose tolerance abnormalities: impaired glucose tolerance (IGT) and type-2 diabetes mellitus (T2-DM). According to OGTT 92, subjects had an IGT and 33 were diagnosed T2-DM. Logistic regression analysis detected a significant association for both LAP and HOMA-IR with single (IGT and T2-DM) and composite (IGT + T2-DM) abnormal glucose tolerance conditions. However, while the association with diabetes was similar between LAP and HOMA-IR, the relationship with IGT and composite outcomes by models including LAP was significantly superior to those including HOMA-IR (P = 0.006 and P = 0.007, resp.). LAP seems to be an accurate index, performing better than HOMA-IR, for identifying 2-hour postload OGTT outcomes in overweight/obese patients with nondiabetic fasting glucose.

Highlights

Impaired glucose tolerance to overt diabetes is substantially regarded as an obesity-related complication [1]
of this paper was accepted for poster presentation
a continuous variable based on waist circumference

Summary

Introduction

Impaired glucose tolerance to overt diabetes is substantially regarded as an obesity-related complication [1]. The pathophysiological role of excessive visceral adiposity in the decline of pancreatic β-cell function is well accepted [2, 3]. A pathologic glucose tolerance and a degree of hyperglycemia sufficient to cause functional changes in various target tissues, but without clinical symptoms, may be present for a long period of time before diabetes is detected [1]. In the identification of subjects with glucose metabolism abnormalities but presenting with normal or mildly increased fasting glucose, not recommended for routine clinical use, the use of a 2-hour postload glucose of an oral glucose tolerance test (OGTT) is an accepted procedure [1]

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