Sex-specific contribution of lipid accumulation product and cardiometabolic index in the identification of nonalcoholic fatty liver disease among Chinese adults

Abstract

Background Lipid accumulation product (LAP) and cardiometabolic index (CMI) are two novel obesity-related indexes associated with enhancing metabolic disease (MD) risk. Current evidences suggest that the differences in sex hormones and regional fat distribution in both sexes are directly correlated with MD and nonalcoholic fatty liver disease (NAFLD) risk. Hence, NAFLD incidences reflect sex differences. Herein, we examined the accuracy of LAP and CMI in diagnosing NAFLD in both sexes. Methods Overall, 14,407 subjects, who underwent health check-up in the northeastern China, were enrolled in this study, and their corresponding LAP and CMI were calculated. Abdominal ultrasonography was employed for NAFLD diagnosis. Multivariate analyses were analyzed potential correlations between LAP and/or CMI and NAFLD. Odds ratios (ORs) and 95% confidence intervals (CIs) were evaluated. Receiver operating characteristic curve analyses was executed for the exploration of the diagnostic accuracies. Areas under the curves (AUCs) with 95%CIs were calculated. Results NAFLD prevalence increased with elevated quartiles of LAP and CMI in both sexes. In multivariate logistic regression analyses, LAP and CM expressed as continuous variables or quartiles, significantly correlated with NAFLD. The ORs for the top versus bottom quartile of LAP and CMI for NAFLD were 13.183 (95%CI = 8.512–20.417) and 8.662 (95%CI = 6.371–11.778) in women and 7.544 (95%CI = 5.748–9.902) and 5.400 (95%CI = 4.297–6.786) in men. LAP and CMI exhibited larger AUCs, compared to other obesity-related indexes in terms of discriminating NAFLD. The AUCs of LAP and CMI were 0.860 (95%CI = 0.852–0.867) and 0.833 (95%CI = 0.825–0.842) in women and 0.816 (95%CI = 0.806–0.825) and 0.779 (95%CI = 0.769–0.789) in men. Conclusions LAP and CMI are convenient indexes for the screening and quantification of NAFLD within a Chinese adult population. Their associations with NAFLD are substantially greater in women than men.

Optimum non-invasive predictive indicators for metabolic dysfunction-associated fatty liver disease and its subgroups in the Chinese population: A retrospective case-control study

“…In a cross-sectional study involving 40,459 participants from southern China, LAP showed a strong association with the diagnosis and severity of NAFLD ( 31 ), in line with findings from northern China ( 11 ). Besides, LAP is one of the few indicators that can reflect sex differences in FLD, which is calculated for males and females respectively.…”

“…Besides, atherogenic index of plasma (AIP) was considered as a regular monitoring index of NAFLD for obese men due to its strong correlation with NAFLD in obese participants ( 9 ). However, most researchers only aimed at one or two parameters without comparison among more indexes ( 10 , 11 ). The latest consensus suggests that there are three subgroups in the diagnosis of MAFLD, including Obesity, Lean, and T 2 DM MAFLD subgroups ( 12 ).…”

Establishment and Validation of a New Predictive Model for Insulin Resistance based on 2 Chinese Cohorts: A Cross-Sectional Study

“…The data from the Third National Health and Nutrition Examination Survey conducted in the United States demonstrated that LAP, which combined abdominal adiposity and circulating TG concentration, was much superior for predicting diabetes than BMI [ 14 ]. Recently, several studies found LAP could be used as an effective predictor of IR and NAFLD, and what's more, it had a relatively higher predictive value than traditionally applied surrogate indices [ 6 , 18 , 20 ]. VAI deriving from a formula based on anthropometric and biochemical parameters could indirectly express visceral adipose function and was a useful marker for evaluating IR in clinical practice [ 15 , 21 ].…”

Curcumin Offers No Additional Benefit to Lifestyle Intervention on Cardiometabolic Status in Patients with Non-Alcoholic Fatty Liver Disease

“…Simple, cost-effective, and non-invasive tests for NAFLD are preferred over liver biopsy, and LAP is a valid alternative [ 43 ]. LAP performs better than BMI as a marker for NAFLD and is also a risk factor for diabetes [ 44 ], metabolic syndrome [ 45 , 46 ], and cardiovascular diseases [ 47 , 48 ].…”

“…In addition, the TyG index is a novel marker with high specificity and sensitivity in diagnosing metabolic syndrome [ 49 ]. Additionally, the best-validated steatosis biomarker-related index is the FLI, which is also helpful for evaluating NAFLD, with a high correlation with imaging and histological findings [ 43 ], as well as being beneficial for assessing CVD, since the risk factors are the same for both [ 43 ]. Furthermore, adipose tissue-related indicators have been correlated with higher morbidity and mortality rate among patients with NAFLD [ 27 , 30 ].…”