Key result
A 1-SD increment in log-transformed lipid accumulation product increased the risk of incident cardiovascular disease by 41% in women (HR 1.41), but its predictive performance was not superior to traditional anthropometric measures.
Why the study?
Does lipid accumulation product (LAP) improve prediction of incident cardiovascular disease or all-cause mortality compared to BMI, WHtR, or WHpR in adults?
Cohort (n=6,751)
No
Does lipid accumulation product (LAP) improve prediction of incident cardiovascular disease or all-cause mortality compared to BMI, WHtR, or WHpR in adults?
Hazard Ratio: 1.41 (95% CI 1.02–1.96)
p-value: p=0.038
Lipid accumulation product (LAP) does not offer superior predictive performance for cardiovascular disease or all-cause mortality compared to traditional anthropometric measures like waist-to-height or waist-to-hip ratios.
LAP offers no predictive advantage over traditional anthropometrics; leaves open its incremental value in sex-specific risk models.
BACKGROUND: The body mass index (BMI) is the most commonly used marker for evaluating obesity related risks, however, central obesity measures have been proposed to be more informative. Lipid accumulation product (LAP) is an alternative continuous index of lipid accumulation. We sought in this study to assess if LAP can outperform BMI, waist-to-height-ratio (WHtR), or waist-to-hip-ratio (WHpR) in predicting incident cardiovascular disease (CVD) or all-cause mortality. RESULTS: Among participants of Tehran Lipid and Glucose Study, 6,751 participants (2,964 men), aged ≥ 30 years, were followed for a median of 8.6 years. We observed 274 deaths (men: 168) and 447 CVD events (men: 257). Levels of common CVD risk factors significantly increased across LAP quartiles. Mortality rates did not differ by LAP quartiles. Among participants free of CVD at baseline [6331 (2,741 men)], CVD incident rates per 1000 person increased in a stepwise fashion with increasing LAP quartile values in both men (from 6.9 to 17.0) and women (from 1.3 to 13.0), (Ps < 0.001). Among women, a 1-SD increment in log-LAP conferred a 41% increased risk for CVD (HR 1.41, 95% CIs 1.02-1.96). Among men, however, LAP was not observed to be independently associated with increased risk of CVD; except in a sub-group of men assigned to the lifestyle modification interventions, where, LAP predicted CVD risk. After adjustment with CVD risk factors LAP turned to be inversely associated with risk of all-cause mortality (HR, men 0.74, 95% CIs 0.61-0.90; women, 0.94 95% CIs 0.74-1.20). Among women, magnitude of increased risk of CVD due to LAP was not different from those of anthropometric measures. Among men, however, WHpR was observed to be more strongly associated with increased risk of CVD than was LAP. Among neither men nor women were the predictive performances (discrimination, calibration, goodness-of-fit) of the LAP better than those of different anthropometric measures were. CONCLUSIONS: If LAP is to be used for predicting CVD, it might not be superior to WHtR or WHpR.
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Bozorgmanesh et al. (2010) conducted a cohort in Cardiovascular disease and all-cause mortality (n=6,751). Lipid accumulation product (LAP) vs. Traditional adiposity measures (BMI, WHtR, WHpR) was evaluated on Incident cardiovascular disease (CVD) per 1-SD increment in log-LAP among women (HR 1.41, 95% CI 1.02-1.96, p=0.038). A 1-SD increment in log-transformed lipid accumulation product increased the risk of incident cardiovascular disease by 41% in women (HR 1.41), but its predictive performance was not superior to traditional anthropometric measures.
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