Background: Lipid accumulation product (LAP) is considered to be a new convenient useful indicator to assess the visceral fat. However, the association between LAP and family history of diabetes remains an undetermined concept. Therefore, we aimed to evaluate the risk factors of impaired fasting glucose (IFG) and diabetes, and explore the possible interacting influences of LAP with other factors on the risk of IFG and diabetes among Chinese normotension adults.Methods: A multistage stratified cluster sampling method was conducted to select urban residents aged 45-86 years in Bengbu, China. For each eligible participant, data on questionnaire survey, anthropometric measurements and laboratory tests were obtained. LAP was calculated and divided into four categories according to quartile. The effects of body mass index (BMI), waist circumference (WC), waist to height ratio (WHtR) and LAP for predicting IFG and diabetes were performed by multiple logistic regressions and receiver operating characteristic (ROC) analyses. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). If the 95% CI of RERI and AP do not include 0, the 95% CI of SI do not include 1, the interactions are statistically significant. Results: 6467 normotension subjects (2695 men and 3772 women) were enrolled in our study, the prevalence of IFG and diabetes were 9.37% and 14.33%, respectively. It was revealed that the prevalence rates of IFG and diabetes were gradually increased according to increasing LAP quartiles (P for trend <0.001). When assessed using ROC curve analysis, LAP exhibited higher diagnostic accuracy for identifying IFG and diabetes than BMI, the area under the AUC curve was 0.650 (95% CI: 0.637 to 0.662). After adjustment for age, sex, educational level and other confounding factors, multivariate logistic regression analyses indicated that subjects with the fourth quartile of LAP were more likely to develop IFG (adjusted OR: 2.735, 95% CI: 1.794-4.170) and diabetes (adjusted OR: 1.815, 95% CI: 1.297-2.541) than those with the first quartile. A significant interaction between LAP and family history of diabetes was observed in participants (RERI=1.538, 95%CI: 0.167 to 3.612; AP=0.375, 95%CI: 0.118 to 0.631; SI=1.980, 95%CI: 1.206 to 3.251), but there is no statistically significant difference between LAP and general obesity. However, a significant interaction between LAP and abdominal obesity was indicated by the value of RERI (1.492, 95%CI: 0.087 to 3.723) and AP (0.413, 95%CI: 0.014 to 0.756), but not the value of SI (1.824, 95%CI: 0.873 to 3.526). Conclusion: LAP significantly associates with IFG and diabetes risk in the study population, it has better performance than BMI, WC and WHtR. Apart from that, our results also demonstrated that there might be synergistic effect between LAP and family history of diabetes on the risk of IFG and diabetes.
Background: Lipid Accumulation Product (LAP) was proposed as a useful indicator of visceral obesity, the visceral obesity and cardiovascular diseases are closely related. However, the empirical evidences of LAP and hypertension (HTN) are limited. Our study sought to assess the risk factors of HTN and prehypertension (PHT), and provide an insight into the possible interacting influences of LAP with family history of HTN on the risk of HTN in the nondiabetic Eastern Chinese population. Methods: A large cross-sectional study was conducted in community health service centers in urban Bengbu of Anhui province, China. All elderly person aged 45 years and older were performed an interview questionnaire, physical measurements and biochemical indicators examinations by trained staffs. Common indexes to screen obese persons such as body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR) and LAP were calculated. Multivariate logistic regression was used to test the prevalence of HTN and PHT in relation to each quartile increase in LAP level and family history of HTN. The receiver operating characteristic (ROC) analysis was applied to calculate the best cut-off value of LAP and identify the superior obesity indicator. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). Results: 7733 subjects were enrolled in our study, the overall prevalence rates of normotension, PHT and HTN were 38.1%, 37.1% and 24.8%, respectively. The prevalence of HTN increased rapidly across LAP quartiles in males and females, the LAP values in the top quartile were significantly higher than those in the bottom quartile (31.8% vs. 17.6% in males, p for trend <0.001; 31.4% vs. 18.8% in females, p for trend <0.001). The AUC value of LAP were superior to BMI in males (Z=6.627, p<0.001) and females (Z=8.045, p<0.001). Multinomial logistic regression analysis showed that compared with subjects in LAP quartile 1, those in quartile 3 (OR: 1.612, 95% CI: 1.386-1.876) and quartile 4 (OR: 1.942, 95% CI: 1.673-2.253) had significantly higher risk of HTN (p for trend<0.001) after adjusting for confounding factors. A significant interaction was observed between LAP and family history of HTN in males (AP: 0.1663, 95% CI: 0.0027-0.3299; SI: 1.4035, 95% CI: 1.0597-1.8590) and females (RERI: 1.4109, 95% CI: 0.1455-2.9674; AP: 0.1664, 95% CI: 0.0088-0.3240; SI: 1.3884, 95% CI: 1.0565-1.8245). Conclusion: LAP is a simple and convenient index to predict the HTN risk, higher LAP values have relatively associated with higher blood pressure (BP). The results demonstrated that interactive effects of LAP with family history of HTN may synergistically influence the development of HTN.
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