Lipid Accumulation Product Index Research Articles

The Lipid Accumulation Product Index (LAP) and the Cardiometabolic Index (CMI) Are Useful for Predicting the Presence and Severity of Metabolic Syndrome in Adult Patients with Obesity

Background: The concomitant occurrence of obesity and metabolic syndrome (MetS) causes a significant worsening of a patient’s clinical condition. Indexes that employ anthropometric measurements alone or associated with blood parameters have been investigated for their ability to identify MetS. This study aimed to evaluate the diagnostic accuracy of three of these indexes, the body adiposity index (BAI), the lipid accumulation product index (LAP), and the cardiometabolic index (CMI), in a cohort of 1912 adult subjects with obesity. Methods and Results: MetS was found in 62.3% of the enrolled subjects, with a higher prevalence in males (72.5%) than females (60.9%). Receiver operating characteristic (ROC) analysis was used to define which index performed better. The BAI was found to be the lowest-performing index, with an ROC area of 0.50, a sensitivity of 30.31%, a specificity of 74.48%, and a likelihood ratio of 1.19. On the contrary, the LAP and the CMI showed a comparable ROC area of 0.82. The LAP had a sensitivity of 63.06%, a specificity of 86.55%, and a likelihood ratio of 4.69, while the CMI had a sensitivity of 67.59%, specificity of 81.55%, and a likelihood ratio of 3.66. The analysis was also performed in the group divided into males and females, with overlapping results. Conclusions: The LAP and the CMI performed better than the BAI in detecting MetS both in the general population with obesity and in the male/female subgroups. In the future, it will be important to validate these useful diagnostic tools in order to employ them in clinical practices.

Can triglyceride related indices be reliable markers in the assessment of polycystic ovarian syndrome?

Abstract Objectives This study aimed to evaluate the diagnostic utility of the Triglyceride Glucose (TyG), Triglyceride Glucose–Body Mass (TyG-BMI), and Lipid Accumulation Product (LAP) indices for both screening Polycystic Ovary Syndrome (PCOS) and diagnosing insulin resistance (IR) in women diagnosed with PCOS. Methods Retrospective data from medical records of 124 women were analyzed, with 71 in the PCOS group and 53 in the non-PCOS group. The PCOS diagnosis followed the 2003 Rotterdam criteria. Basic clinical and biochemical parameters were compared. The TyG index was computed using the formula ln [Triglyceride (TG) (mmol/L) × fasting plasma glukose (FPG) (mg/dL)/2]. TyG-BMI value was derived as TyG × BMI. LAP was calculated as (waist circumference (WC-58) × TG (mmol/L). IR was identified if Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was >2.7. Results TyG-BMI (AUC=0.62) and LAP indices (AUC=0.61) did not demonstrate statistically significant diagnostic performance for PCOS. Regarding IR in PCOS patients, the highest AUC was for TyG-BMI (0.84, 95 % CI: 0.73–0.93, p<0.001) with a cutoff at 116.15, showing 80 % sensitivity and 86 % specificity. LAP had an AUC of 0.86 with a cutoff of 30.21 (sensitivity 80 %, specificity 81 %), while TyG showed an AUC of 0.78 (95 % CI: 0.67–0.89, p<0.001) with a cutoff of 4.47, demonstrating a sensitivity of 70 % and specificity of 72 %. Conclusions Numerous biochemical markers have been explored for PCOS detection, however, many are expensive, not universally available, and necessitate specific test kits. TyG, TyG-BMI, and LAP indices might not serve as reliable markers for PCOS screening but could offer utility in identifying IR in Turkish women diagnosed with PCOS.

Relationship between body adiposity parameters and insulin resistance: a preliminary study of surrogate markers in Japan.

According to the Japan National Health and Nutrition Survey 2019, the proportion of people with prediabetes is estimated to be 27.3%. Western-style dietary habits can lead to obesity and a functional abnormality of the adipose tissue, which can cause insulin resistance and predispose one to diabetes. We examined the relationship between insulin resistance using body adiposity parameters as surrogate markers. This study enrolled 248 healthy participants to determine the association of six body adiposity parameters, namely, body mass index (BMI), waist circumference (WC), visceral adiposity index (VAI), lipid accumulation product index (LAP), waist circumference-triglyceride index (WTI), and triglyceride (TG)/high-density lipoprotein (HDL) ratio with insulin resistance. Receiver operating characteristics curve analyses were performed to assess the accuracy of these parameters in identifying insulin resistance. The data of the 248 participants (women 79 and men 169) were examined in this study. WC showed the highest accuracy in the obese women group (cut-off value: 89.8 with sensitivity: 0.900 and specificity: 0.522, AUC: 0.680) and men group (cut-off value: 90.0 with sensitivity: 0.862 and specificity: 0.508, AUC: 0.701). The TG/HDL ratio showed the highest accuracy in men with non-obesity (cut-off value: 0.8 with sensitivity: 0.857 and specificity: 0.649, AUC: 0.780). Application of this finding should be useful in the early screening of obesity in men with non-obesity, such as during regular health check-up with the TG/HDL ratio in addition to the usually used WC, to assess insulin resistance and prevent lifestyle-related diseases that can lead to cardiovascular events.

Anthropometric and Biochemical Correlations of Insulin Resistance in a Middle-Aged Maltese Caucasian Population.

Insulin resistance (IR) is associated with increased cardiovascular disease risk, and with increased all-cause, cardiovascular, and cancer mortality. A number of surrogate markers are used in clinical practice to diagnose IR. The aim of this study was to investigate the discriminatory power of a number of routinely available anthropometric and biochemical variables in predicting IR and to determine their optimal cutoffs. We performed a cross-sectional study in a cohort of middle-aged individuals. We used receiver operator characteristics (ROC) analyses in order to determine the discriminatory power of parameters of interest in detecting IR, which was defined as homeostatic model assessment-insulin resistance ≥2.5. Both the lipid accumulation product (LAP) and visceral adiposity index (VAI) exhibited good discriminatory power to detect IR in both males and females. The optimal cutoffs were 42.5 and 1.44, respectively, in males and 36.2 and 1.41, respectively, in females. Serum triglycerides (TG) and waist circumference (WC) similarly demonstrated good discriminatory power in detecting IR in both sexes. The optimal cutoffs for serum TG and WC were 1.35 mmol/L and 96.5 cm, respectively, in men and 1.33 mmol/L and 82 cm, respectively, in women. On the other hand, systolic and diastolic blood pressure, liver transaminases, high-density lipoprotein cholesterol, serum uric acid, ferritin, waist-hip ratio, "A" body shape, thigh circumference, and weight-adjusted thigh circumference all had poor discriminatory power. Our data show that LAP, VAI, TG, and WC all have good discriminatory power in detecting IR in both men and women. The optimal cutoffs for TG and WC were lower than those currently recommended in both sexes. Replication studies are required in different subpopulations and different ethnicities in order to be able to update the current cut points to ones which reflect the contemporary population as well as to evaluate their longitudinal relationship with longer-term cardiometabolic outcomes.

Sex-specific differences in the associations between adiposity indices and incident hyperuricemia among middle-aged and older adults: a nationwide longitudinal study.

Although obesity is a known risk for hyperuricemia (HUA), the associations between adiposity indices and incident HUA and whether sex-specific differences exist is still unknown. We aimed to investigate theassociations between adiposity indices and incident HUA in a longitudinal study. Data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011-2012 and 2015-2016 were used to conduct a cohort study. Participants aged ≥45 years without HUA at baseline were included in this study. Adiposity indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio body roundness index (BRI), conicity index (CI), lipid accumulation product (LAP) index, waist-to-height ratio (WHtR), visceral adiposity index (VAI), and Chinese visceral adiposity index (CVAI), were calculated. Logistic analysis was used to analyze the association between adiposity indices and incident HUA risk stratified by gender. Receiver operating characteristic curve analysis was performed to evaluate the power of predictions for incident HUA. Of 5,873 participants aged 59.0 ± 8.7 years enrolled in this study, 578 (9.8%) participants developed HUA during the 4-year follow-up period. After adjusting for confounding variables, LAP, VAI, and CVAI showed significant association with incident HUA. BMI, WC, WHtR, BRI, and CI were significantly associated with incident HUA in women but not in men. LAP had the highest area under the curve (AUC) (0.612) followed by CVAI (0.596) in men, while CVAI had the highest AUC (0.707) followed by LAP (0.691) in women. All indices showed better predictive ability in women than in men. Our findings indicated that adiposity indices were effective predictors of incident HUA and showed better predictive power in women than men. In clinical practice, adiposity indices could be used to assess and prevent incident HUA among Chinese middle-aged and older adults.

Association between systemic immune-inflammatory index and diabetes mellitus: mediation analysis involving obesity indicators in the NHANES.

Inflammation and obesity have been widely recognized to play a key role in Diabetes mellitus (DM), and there exists a complex interplay between them. We aimed to clarify the relationship between inflammation and DM, as well as the mediating role of obesity in the relationship. Based on the National Health and Nutrition Examination Survey (NHANES) 2005-2018. Univariate analyses of continuous and categorical variables were performed using t-test, linear regression, and χ2 test, respectively. Logistic regression was used to analyze the relationship between Systemic Immune-Inflammatory Index (SII) or natural logarithm (Ln)-SII and DM in three different models. Mediation analysis was used to determine whether four obesity indicators, including body mass index (BMI), waist circumference (WC), visceral adiposity index (VAI) and lipid accumulation product index (LAP), mediated the relationship between SII and DM. A total of 9,301 participants were included, and the levels of SII and obesity indicators (BMI, WC, LAP, and VAI) were higher in individuals with DM (p < 0.001). In all three models, SII and Ln-SII demonstrated a positive correlation with the risk of DM and a significant dose-response relationship was found (p-trend <0.05). Furthermore, BMI and WC were associated with SII and the risk of DM in all three models (p < 0.001). Mediation analysis showed that BMI and WC mediated the relationship between SII with DM, as well as Ln-SII and DM, with respective mediation proportions of 9.34% and 12.14% for SII and 10.23% and 13.67% for Ln-SII (p < 0.001). Our findings suggest that increased SII levels were associated with a higher risk of DM, and BMI and WC played a critical mediating role in the relationship between SII and DM.

Association between lipid accumulation product index and lower urinary tract symptom—benign prostatic hyperplasia: a 7-year follow-up study

The distribution of adipose tissue plays a crucial role in the progression of lower urinary tract symptoms suggestive of benign prostate hyperplasia (LUTS/BPH). This study was performed to explore the longitudinal association between the lipid accumulation product index (LAPI) and LUTS/BPH. Based on logistic and restricted cubic spline (RCS) regressions, data from the China Health and Retirement Longitudinal Study were used to evaluate the odds ratio (OR) and non-linear correlation between LAPI and LUTS/BPH. Subgroup and interactive analyses were adopted to determine the interactive effects of covariates. In addition, a 7-year retrospective cohort from 2011–2018 was constructed to investigate the longitudinal association. After data cleansing, this study included 3967 males aged &gt;40 years in 2011. In the full model, high LAPI was significantly associated with prevalent LUTS/BPH (OR = 1.007; 95% CI (confidence interval): 1.001–1.013, p = 0.016). Furthermore, as a categorical variable, the ORs were 1.21 (95% CI = 0.91–1.62, p = 0.197) and 1.56 (95% CI = 1.09–2.23, p = 0.014) for the second and third tertile groups, respectively. No significant interactive effects were detected (all p for interaction &gt; 0.05). The RCS regression revealed a linear association between LAPI and prevalent LUTS/BPH in the overall population (p for overall &lt; 0.05) and an L-shaped association in males aged ≥60 years (p for non-linear = 0.006). In the 2011–2018 cohort, the ORs for the second and third tertile groups were 1.51 (95% CI = 1.11–2.04, p = 0.008) and 1.74 (95% CI = 1.21–2.50, p = 0.003) in the full models, respectively. All the sensitivity analyses supported similar findings. In conclusion, aging males with high LAPI have a higher risk of developing LUTS/BPH than their counterparts.

The effect of cumulative lipid accumulation product and related long-term change on incident stroke: The Kailuan Study

Background and aimsA single measurement lipid accumulation product (LAP) level has been shown to increase cardiovascular disease, but cumulative LAP on stroke effects is uncertain. Methods and resultsThis study included 43,089 participants, free of any cardiovascular diseases at baseline, from the Kailuan Study. The cumulative LAP was determined by multiplying the average LAP index and the time interval between two consecutive examinations, resulting in their categorization into four quartile groups. The higher LAP exposure was defined as participants with LAP values exceeding 90% of this population during each health survey. The association between cumulative LAP and stroke was assessed using multivariable Cox proportional hazard models. During a median follow-up period of 11.0 (10.6–11.3) years, 2461 participants developed stroke (of which 2220 were ischemic stroke, 320 were hemorrhagic stroke, and 79 were concurrent). After adjusting for potential confounders, the risk of stroke gradually increased in Groups Q2 to Q4 compared to Q1, with hazard ratios (HRs) ranging from 1.19 (95% CI: 1.05–1.36) to 1.50 (95% CI: 1.30–1.70). Specifically, the risk of ischemic stroke showed an increase from 1.21 (1.06–1.39) to 1.56 (1.36–1.79), while no statistically significant effect was observed for hemorrhagic stroke. The longer duration of higher LAP index exposure was also associated with increased stroke risk. Similar results were obtained in the stratification and sensitivity analyses. ConclusionCumulative LAP was positively and significantly associated with incident stroke, especially ischemic stroke, and a longer duration of exposure to higher LAP may increase the risk of stroke.

Abnormal adiposity indices are associated with an increased risk of diabetes in a non-obese Asian population

ObjectivesThe aim of this study was to evaluate the association between adiposity indices and the risk of incident diabetes and to compare their predictive ability in non-obese healthy individuals. Study designPopulation-based cohort study. MethodsData were taken from the NAGALA research study, which enrolled Japanese adults aged 18–79 years. Cox regression was used to evaluate the association between adiposity indices (including waist circumference [WC], waist-to-height ratio [WHtR], lipid accumulation product index [LAP], body roundness index [BRI], visceral adiposity index [VAI] and Chinese visceral adiposity index [CVAI]) and diabetes risk. The performance of the indices for predicting diabetes was explored using area under the receiver operating characteristic curve (AUC). A Chinese community–based population was used for validation. ResultsA total of 12,940 healthy Japanese individuals with normal body mass index and glycaemic levels were included and were followed up for a median of 6 years. Multivariable Cox models revealed a positive and significant association between all indices and incident diabetes, with the hazard ratios for the highest quartile of the indices ranging from 1.89 to 2.90 (all P-values < 0.01). A non-linear association between WC, BRI and VAI and a linear association between WHtR, LAP and CVAI and diabetes risk were observed. CVAI, VAI and LAP had comparable ability in predicting diabetes, with the highest AUC being 0.733 for CVAI. Data from 10,830 Chinese individuals confirmed these results. ConclusionsAdiposity indices are associated with incident diabetes in healthy non-obese individuals. Participants in the highest quartile of WC, WHtR, LAP, BRI, VAI and CVAI had an increased risk of developing diabetes.

Comparative Evaluation of Lipid Accumulation Product, and Triglyceride-Glucose Indices in Apparently Healthy Subjects in Predicting Cardiovascular Risks in Port-Harcourt

Lipid accumulation product is a novel biomarker of central lipid accumulation related to the risk of diabetes and cardiovascular diseases. In certain metabolic diseases, insulin resistance is often present which could be attributed to an abnormality in the insulin-specific receptors in various tissues, obesity, or visceral adiposity. This study aimed at determining the triglyceride–glucose index and lipid accumulation product index of apparently healthy individuals in Port Harcourt. A total of 150 healthy individuals were assessed for anthropometric and biochemical measurement, lipid accumulation production (LAP), and triglyceride --glucose index TyG. Comparison of mean values of biophysical variables body mass index (BMI), lipid accumulation product indices, cardiovascular, triglyceride–glucose index, insulin, C-peptide, glycated haemoglobin (HbAIC), Fasting blood sugar (FBS), and Body Mass Index (BMI) of male and female subjects were measured using standard procedures. A detailed comparison of mean values of biophysical variables of male and female subjects shows that the mean age for the male subjects (41.55±6.99 years) was significantly higher (p=0.0159) when compared to the mean age for female subjects (39.04±5.6 years. There was no significant difference in the mean weight, height, BMI, waist circumference, SBP, DBP, T. Chol, triglyceride, HDL, LDL, C-peptide level, HbAIc, FBS level, T. CHOL/HDL ratio, T. CHOL/LDL ratio, and TyG index between the male and female subjects. However, there was a significantly higher level of insulin for male than female subjects and higher LAP for female than male subjects. Also, there was a higher HOMA-R for male subjects than female subjects. Additionally, there was a positive correlation between BMI and the following; mean age, systolic blood pressure (SBP), diastolic blood pressure (DBP), waist circumference (WC), and insulin levels.   The Receiver's Operating Characteristics (ROC) curve for the LAP test had a high AUC value of 0.9970. Similarly, the ROC curve analysis of the TyG test had a high AUC of 0.8344. However, these findings emphasize the LAP test has a stronger discriminatory ability than TyG. Healthy individuals may have the cardiovascular risk of being evaluated by LAP, which is very cost-effective.

Novel anthropometric parameters in the adult population with prediabetes.

Although it is assumed that novel-derived anthropometric indices can better reflect cardiometabolic risk than traditional ones, the results are conflicting. Previous studies have mainly focused on patients with type 2 diabetes mellitus. However, studies conducted on populations with prediabetes are scarce. The present study aimed to examine the potential relationship between prediabetes and novel anthropometric parameters [that is, cardiometabolic index (CMI), visceral adiposity index (VAI), lipid accumulation product index (LAP), body roundness index (BRI), and body adiposity index (BAI)] and traditional parameters [that is, waist circumference (WC), hip circumference (HC), body mass index (BMI), waist-to-height ratio (WHtR), and waist-to-hip ratio (WHR)] in adults with prediabetes. This case-control cross-sectional study included 177 patients with prediabetes and 609 control subjects. Biochemical and simple anthropometric parameters were measured (WC, HC, body weight, and height), whereas the other parameters were calculated. WC, CMI, VAI, and LAP independently correlated with prediabetes. Principal component analysis (PCA) was used to extract several factors that correlated with prediabetes. Significant predictive capability was demonstrated for non-traditional anthropometric/lipid-related factors and WHipR-related factors for prediabetes (OR=1.334 and OR=1.202, respectively). However, only non-traditional anthropometric/lipid-related factors (i.e., VAI, CMI, and LAP) demonstrated an independent significant positive relationship with prediabetes in multivariate binary regression analysis. CMI, VAI, and LAP could be superior to BAI, BRI, and conventional anthropometric parameters for discriminating patients with prediabetes in the adult population. Prospective trials are needed to confirm our results.

Association Between Visceral Adiposity Marker with Diabetic Kidney Disease: An Analysis of Data from National Diabetes Registry Malaysia

Diabetic kidney disease (DKD) causes significant morbidity and mortality and an economic burden to the country. New visceral adiposity assessment and measurements have gained much attention as a surrogate marker to screen pathogenic visceral fat among patients with chronic kidney disease. This study aims to determine the association between visceral adiposity markers and DKD among T2DM patients. A cross-sectional study to analyze Putrajaya Diabetes Clinical Audit 2018 data from the National Diabetes Registry Malaysia was conducted. A universal sampling method was performed to include all T2DM patients in the dataset. Logistic regression analyses were utilized for three visceral adiposity markers, which were the hypertriglyceridemic waist (HW) phenotype, visceral adiposity index (VAI) and lipid accumulation product index (LAPI). A total of 1,297 T2DM patients were included in the analyses. The majority of them were of Malay ethnicity, male and aged between 40-64 years. The overall prevalence of DKD was 24.1%. VAI was significantly associated with DKD among males but not in females. Compared to males in the first VAI quartile group, both second and fourth quartile groups had increased odds of DKD [adjusted odds ratio (AOR) of 1.91 (95% confidence interval [CI]: 1.09, 3.34) and AOR 2.29 (95% CI: 1.03, 5.09) respectively)]. There was no significant association between HW phenotype and LAPI with DKD. VAI could predict DKD only in male T2DM patients. Thus, it might be a useful clinical indicator of DKD in male T2DM patients in primary care.

OR25-06 The Effect of Testosterone Replacement Therapy on NAFLD in Elderly Hypogonadal Men

Abstract Disclosure: H. Lee: None. S. Han: None. R.S. Swerdloff: None. Y. Pak: None. M.J. Budoff: None. C.C. Wang: None. The Effect of Testosterone Replacement Therapy on NAFLD in Elderly Hypogonadal Men Background: Aging increases body weight, visceral fat, insulin resistance and metabolic syndrome, leading to increased prevalence of nonalcoholic fatty liver disease(NAFLD) in elderly. Testosterone deficiency, more prevalent in elderly men, is associated with metabolic syndrome and increased visceral fat. The T Trials evaluated the effect of testosterone treatment on sexual function, physical function, and vitality. A substudy on the effect of testosterone on cardiovascular markers showed decrease in total cholesterol, LDL cholesterol, HDL cholesterol, fasting insulin level and HOMA-IR in testosterone treatment group compared to placebo. We hypothesized that testosterone replacement in elderly male with hypogonadism will improve NAFLD. Methods: Data from the T Trial was used to evaluate prevalence of NAFLD using 3 clinical scores in testosterone treatment group and placebo group; Lipid accumulation product (LAP) index, hepatic steatosis index (HSI) and NAFLD-MS score. A randomized sub-group of the placebo and testosterone treated subjects had cardiac CT (Computed tomography) that includes liver and spleen. Liver Hounsfield unit (HU) and spleen HU were obtained to evaluate NAFLD by CT criteria. Clinical liver fat scores and CT findings were evaluated at baseline and 12 months post treatment. Correlation between each liver fat score (LAP index, HSI and NAFLD-MS score) and liver CT findings were analyzed. Results: 502 male of age 65 and over with total testosterone &amp;lt;275ng/dL were analyzed (testosterone group n= 246, placebo group n=233). Baseline testosterone levels were not different between the two groups at baseline. Testosterone level was increased by 285.5±266.4ng/dL in the treatment group compared to 1.98±73.6ng/dL in the placebo group (p= 0.0001). Prevalence of NAFLD in elderly hypogonadal men by LAP index, HSI and NAFLD-MS were 89.77%, 88.93% and 3.96% respectively. 30% of subjects had liver HU&amp;lt;40, 21.36% had liver-to-spleen HU ratio (LSR)&amp;lt;1. There were no statistically significant changes in liver fat scores and CT findings in each arm at baseline and after 12 months treatment. Subgroup analysis on subjects with NAFLD defined by LAP index, liver HU or LSR did not show improvement of NAFLD after 12 months of testosterone replacement. Among the 3 liver fat scores, only LAP index showed inverse correlation with liver HU. Conclusion: Our study did not show improvement of NAFLD in elderly hypogonadal male after 12 months of testosterone replacement compared to placebo, assessed by lipid accumulation product index, hepatic steatosis index, NAFLD-MS score, liver HU and liver-to-spleen ratio. Future studies with longer treatment duration and additional modalities to define NAFLD as primary outcome may be warranted. Presentation Date: Saturday, June 17, 2023

Lipid accumulation product and visceral adiposity index for incidence of cardiovascular diseases and mortality; results from 13years follow-up in Isfahan cohort study.

/Aims: Visceral adiposity index (VAI) and lipid accumulation product (LAP) are novel anthropometric indices that have shown an association with metabolic syndrome; however, limited data are available regarding the predictive performance of these indices for the incidence of cardiovascular diseases (CVD) and mortality. This study was performed on the data retrieved from Isfahan Cohort Study (ICS). ICS is an ongoing population-based cohort study conducted in 3 counties in central Iran. Pearson correlation analysis was performed between LAP, VAI, and metabolic parameters. Cox regression analysis and receiver operative characteristics (ROC) curve analysis were performed in order to evaluate the ability of VAI and LAP for the incidence of CVD, CVD-associated mortality, and all-cause mortality. We further compared the predictive performance of VAI and LAP with body mass index (BMI). LAP and VAI were significantly correlated with all metabolic variables, including blood pressure, fasting blood glucose, and lipid profile components. Univariate regression analysis indicated a significant association between LAP and VAI and CVD incidence. In multivariate analysis, only VAI was significantly associated with CVD incidence. Regarding CVD mortality, only VAI in the multivariate analysis revealed a significant association. Interestingly, Both VAI and LAP were negatively associated with all-cause mortality. ROC curve analysis indicated the superior performance of LAP and VAI for predicting CVD incidence compared to BMI; however, BMI was better in predicting all-cause mortality. Compared to BMI, LAP and VAI have better predictive performance for the incidence of CVD. In contrast, BMI was superior to VAI and LAP in the prediction of all-cause mortality.

Anthropometric Measures of Adiposity as Markers of Kidney Dysfunction: A Cross-Sectional Study.

The present study was designed to provide information on the ability of several different anthropometric markers to reflect the renal impairment associated with body weight increase and to predict the development of renal alterations linked to overweight and obesity. In 574 subjects representative of the general population of the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study, with an age range between 57 and 73 years, we investigated the association between different anthropometric markers of body fat, as alternative to body mass index, and renal failure, to obtain information useful for determining their potential predictive value. Renal dysfunction was significantly associated with almost all anthropometric markers of adiposity related to body weight and body shape. After adjustment for confounders, such as age, sex, office blood pressure, serum glucose, antihypertensive drugs and smoking habit, association remained significant only for waist-to-hip ratio (WHR), lipid accumulation product (LAP) and visceral adiposity index (VAI). These 3 markers also displayed at the receiver operating curves (ROC) analysis the best ability to detect subjects with or without kidney dysfunction. The results of the present study provide evidence that WHR, LAP and VAI represent the best markers of renal dysfunction associated with visceral body fat accumulation.

Associations of lipid accumulation product, visceral adiposity index, and triglyceride-glucose index with subclinical organ damage in healthy Chinese adults.

Obesity is an independent risk factor for cardiovascular disease development. Here, we aimed to examine and compare the predictive values of three novel obesity indices, lipid accumulation product (LAP), visceral adiposity index (VAI), and triglyceride-glucose (TyG) index, for cardiovascular subclinical organ damage. A total of 1,773 healthy individuals from the Hanzhong Adolescent Hypertension Study cohort were enrolled. Anthropometric, biochemical, urinary albumin-to-creatinine ratio (uACR), brachial-ankle pulse wave velocity (baPWV), and Cornell voltage-duration product data were collected. Furthermore, the potential risk factors for subclinical organ damage were investigated, with particular emphasis on examining the predictive value of the LAP, VAI, and TyG index for detecting subclinical organ damage. LAP, VAI, and TyG index exhibited a significant positive association with baPWV and uACR. However, only LAP and VAI were found to have a positive correlation with Cornell product. While the three indices did not show an association with electrocardiographic left ventricular hypertrophy, higher values of LAP and TyG index were significantly associated with an increased risk of arterial stiffness and albuminuria. Furthermore, after dividing the population into quartiles, the fourth quartiles of LAP and TyG index showed a significant association with arterial stiffness and albuminuria when compared with the first quartiles, in both unadjusted and fully adjusted models. Additionally, the concordance index (C-index) values for LAP, VAI, and TyG index were reasonably high for arterial stiffness (0.856, 0.856, and 0.857, respectively) and albuminuria (0.739, 0.737, and 0.746, respectively). Lastly, the analyses of continuous net reclassification improvement (NRI) and integrated discrimination improvement (IDI) demonstrated that the TyG index exhibited significantly higher predictive values for arterial stiffness and albuminuria compared with LAP and VAI. LAP, VAI, and, especially, TyG index demonstrated utility in screening cardiovascular subclinical organ damage among Chinese adults in this community-based sample. These indices have the potential to function as markers for early detection of cardiovascular disease in otherwise healthy individuals.

Accuracy of visceral adiposity indices and lipid accumulation products in the identification of adults at high cardiovascular risk

IntroductionThe lipid accumulation product (LAP) and visceral adipose index (VAI) are clinical markers of visceral obesity and were proposed as simple tools to estimate cardiovascular risk and mortality. The objective of this study was to analyze the accuracy of the VAI and LAP for high cardiovascular risk patients. MethodsA cross-sectional observational study of accuracy was carried out in 193 patients of both sexes. In addition to the variables VAI and LAP, presence of comorbidities, education, level of physical activity and anthropometric data were obtained. Cardiovascular risk was determined by the Framingham score. ResultsNo significant difference was observed in the sample in gender distribution (44.6% women; 55.4% men), 24.4% had low cardiovascular risk, 48.7% intermediate risk and 26.9% high cardiovascular risk. Linear regression analysis showed that VAI and LAP explain, respectively, only 2.4% and 5.2% of the variation in cardiovascular risk expressed by the Framingham score. The analysis of areas under the curve (AUC) for receiver operating characteristic (ROC) indicated a significant effect only of LAP to diagnose individuals with high cardiovascular risk, but with low sensitivity and specificity. ConclusionOur results indicate that VAI and LAP explain only a small percentage of the variation in the Framingham cardiovascular risk score. LAP index still deserves more attention in a cohort study, because, even with the limitations of a cross-sectional study, we observed an acceptable sensitivity for it so that the LAP can be used as a screening criterion for requesting more accurate tests.

The Effect of Testosterone Replacement Therapy on Nonalcoholic Fatty Liver Disease in Older Hypogonadal Men.

Male hypogonadism is associated with visceral obesity and the metabolic syndrome: factors important for the development of nonalcoholic fatty liver disease (NAFLD). The Testosterone Trials (The T Trials) showed testosterone (T) treatment compared with placebo in older hypogonadal men was associated with decreases in cholesterol and insulin levels suggesting that T treatment may improve NAFLD. Compare effects of T vs placebo treatment on NAFLD scores and liver scans in elderly hypogonadal men. Secondary data analyses from 479 older hypogonadal men with total T < 275 ng/dL from The T Trials were performed. Three clinical liver fat scores-lipid accumulation product index, hepatic steatosis index, nonalcoholic fatty liver disease-metabolic syndrome score-and liver computed tomography (CT) Hounsfield units and liver to spleen ratio were evaluated at baseline and 12 months after treatment. There were no statistically significant differences of change in lipid accumulation product index (P = .98), hepatic steatosis index (P = .67), and nonalcoholic fatty liver disease-metabolic syndrome (P = .52) in 246 men treated with T compared with 233 treated with placebo for 12 months. Liver CT showed no statistically significant difference of change in Hounsfield units (P = .24; n = 71 for T, n = 69 for placebo) and liver to spleen ratio (P = .74; n = 55 for T, n = 62 for placebo) between the 2 groups. Our study did not show improvement of NAFLD in older hypogonadal men after 12 months of T vs placebo treatment, as assessed by 3 clinical scores and liver CT for hepatic steatosis. Future studies with longer treatment duration and additional NAFLD diagnostic modalities as primary outcome are warranted.

Association of neck circumference-related indices with metabolic, atherogenic and liver function biomarkers in patients with non-alcoholic fatty liver disease: a cross-sectional study

ObjectiveThe present study aimed to establish the association of neck circumference (NC)-related indices with metabolic, atherogenic and liver function biomarkers in patients with non-alcoholic fatty liver disease (NAFLD).DesignCross-sectional study.SettingOutpatient clinics...

Interrelation between the lipid accumulation product index and diabetic kidney disease in patients with type 2 diabetes mellitus.

The purpose of this study was to determine the relation between the lipid accumulation product index (LAPI) and diabetic kidney disease (DKD) in patients with type 2 diabetes mellitus (T2DM). Herein, 931 patients were enrolled and their data were collected. Then the interrelation between LAPI and DKD was assessed using multivariate logistic regression analyses (LRAs) and by a restricted cubic spline (RCS). In total, 931 participants (352 females and 579 males) aged 55 years on average were included in the study. After adjusting for several confounders, the odds ratio for DKD was increased evidently in the third LAPI tertile compared with that in the first LAPI tertile. In addition, the RCS revealed a positive interrelation between LAPI and DKD. In the subgroup analyses, age, sex, hyperlipidemia, hypertension, and HbA1c did not significantly interact with LAPI. LAPI was higher in the DKD group than in the no-DKD group, and LAPI is positively linked with DKD, which may have potential value to diagnose DKD in clinical practice.