T he metabolic syndrome is a constellation of cardiovascular and metabolic risk factors associated with insulin resistance, which predisposes individuals to diabetes, and appears to be a multifactorial risk factor for cardiovascular disease, although its clinical significance remains controversial (1). Since it may become useful to be able to predict who will develop metabolic syndrome, we explored the value of lipid accumulation product (LAP), a novel index of central lipid accumulation, which has been associated with cardiovascular disease (2) and diabetes (3). LAP is based on a combination of waist circumference and triglyceride: [LAP ϭ (WC Ϫ 65) ϫ TG for men and (WC Ϫ 58) ϫ TG for women] (2), where TG is triglyceride and WC is waist circumference.We conducted a cross-sectional population-based survey on metabolic syndrome in Argentinian healthy individuals in order to identify single parameter/ index as LAP/surrogates of insulin resistance, with high efficiency in predicting metabolic syndrome. After obtaining ethics committee approval, we recruited (from the Department of Hemotherapy of the Hospital "José de San Martín," University of Buenos Aires) 601 healthy, unrelated male blood donors who had normal findings on medical examinations and were not taking antihypertensive medications. Their ages ranged between 18 and 65 years (mean Ϯ SD 36.9 Ϯ 10.8 years). Clinical and biochemical (lipids, glucose, and insulin) measurements were performed using standardized procedures. Metabolic syndrome was assessed using the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ ATP III) criteria (1). Homeostasis model assessment (HOMA), quantitative insulin sensitivity check index (QUICKI), and LAP were calculated.The prevalence of NCEP/ATP IIIdefined metabolic syndrome was 26.3%.Receiver operating characteristic curves were built for 552 men. The LAP showed the best area under the curve (AUC) for metabolic syndrome (0.91) and was significantly higher than all variables including HOMA of insulin resistance (P Ͻ 0.0001), QUICKI (P Ͻ 0.0001), and triglyceride-to-HDL cholesterol ratio (P ϭ 0.0385). The overall performance of the LAP was similar when individuals were stratified into quartiles for age: quartile 1 (18 -28 years; AUC 0.95), quartile 2 (28 -36 years; 0.93), quartile 3 (36 -45 years; 0.81), and quartile 4 (45-65 years; 0.91). Analysis across quartiles demonstrated that AUCs of LAP were significantly higher than those of fasting insulin, HOMA of insulin resistance, and QUICKI, but not significantly higher than AUCs of triglyceride-to-HDL cholesterol ratio. The AUC of triglyceride-to-HDL cholesterol ratio was the second-highest AUC in the whole sample (0.86) and in quartiles 2 (0.89), 3 (0.78), and 4 (0.89).These findings were confirmed using 20,000 bootstrap samples. The cutoff 53.63 of LAP showed the highest diagnostic accuracy for metabolic syndrome (sensitivity 0.83, specificity 0.83, Younden's index 0.66, predictive value of positive test 0.62, and predictive value of negative test 0.93), and t...

Background:The Pro12Ala polymorphism (rs1801282), a nonsynonymous substitution of peroxisome proliferator-activated receptor-γ (PPARG), has been robustly associated with type 2 diabetes. However, its role in metabolic syndrome (MetS) remains poorly understood. The associations among rs1801282, MetS and surrogate measures of insulin resistance (IR) were investigated in the present study. Methods and Results:A cross-sectional population-based survey of 572 unrelated healthy male Argentinian blood donors with normal findings on medical examination and not taking any medication was conducted. MetS was assessed using the National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III) criteria, and the HOMA-IR, and QUICKI were calculated. Genotyping of rs1801282 was performed using RFLP-PCR. The prevalence of MetS was 26.2%. The Pro/Ala genotype (and the Ala12 allele) was associated with a high risk for MetS (odds ratio (OR) 1.67 [95% confidence interval (CI) 1.03-2.72], P=0.0394). This was highlighted among nonsmokers (OR 2.20 [95%CI 1.25-3.88], P=0.0059). ANCOVA confirmed an interaction between smoking status and this association (P=0.031). Ala12 carriers had a higher waist circumference than noncarriers (P=0.0065). Among nonsmokers, surrogates of IR, such as HOMA-IR, were significantly higher in Ala12 carriers than in noncarriers (P<0.05). Conclusions: Healthy men, in particular nonsmokers, carrying the Ala12 allele of PPARG rs1801282 polymorphism, have a high risk for MetS and IR. (Circ J 2009; 73: 2118 -2124