Association of Lipid Accumulation Product With Chronic Kidney Disease in Chinese Community Adults: A Report From the REACTION Study

Abstract

Background: Limited studies regarding the relationship between lipid accumulation product (LAP), a novel surrogate marker of visceral adiposity, and declined estimated glomerular filtration rate (eGFR) have yielded conflicting findings, and no report has demonstrated the relationship of LAP with chronic kidney disease (CKD), defined by lower eGFR and/or the presence of albuminuria. This study aimed to estimate the possible association between LAP and CKD in Chinese community adults. Method: This cross‐sectional study, drawn from the REACTION study, included 7072 participants aged ≥40 years in Luzhou city, Sichuan Province. LAP was determined based on a combination of waist circumference (WC) and fasting triglycerides (TG). CKD was defined as eGFR <60mL/min/1.73m² and/or presence of albuminuria [urinary albumin‐creatinine ratio (ACR) ≥30mg/g]. A multiple logistic regression model was performed to evaluate the possible association between LAP and CKD in Chinese community adults. Results: Participants with CKD had significantly higher LAP, age, WC, weight, body mass index, systolic blood pressure, diastolic blood pressure, pulse pressure (PP), TG, total cholesterol (TC), fasting blood glucose, 2 h postload blood glucose, glycated hemoglobin A1C, serum creatinine, urinary ACR, prevalence of obesity, type 2 diabetes mellitus, hypertension, myocardial infarction, coronary heart disease, peripheral arterial disease, cardiovascular disease (CVD), users of hypoglycemic drugs, and lower high density lipoprotein cholesterol, eGFR, and users of drinking (P<0.01 or P<0.05). Multiple logistic regression analysis demonstrated that LAP quartiles were positively associated with an increased risk of prevalent CKD (Q2: odds rate [OR]: 1.083, 95% confidence intervals [CI] 0.850-1.381; Q3: OR: 0.961, 95% CI 0.741-1.247; Q4: OR: 1.497, 95% CI 1.139-1.966, P for trend = 0.004) even after adjustment for potential confounding factors. Stratified analysis revealed that the associations of LAP quartiles with increased risk of prevalent CKD also occurred in people who were older, women, overweight, with hypertension, normal glucose tolerance, normal PP, low-density lipoprotein cholesterol < 3.4 mmol/L, without CVD events, no smoking and drinking. Conclusions: These findings suggest that LAP is significantly associated with increased risk of prevalent CKD in Chinese community adults, and may inform both public health recommendations and clinical practice.