The Lipid Accumulation Product Is Associated With Increased Mortality in Normal Weight Postmenopausal Women

Abstract

Lipid accumulation product (LAP) is an emerging cardiovascular risk factor, which is calculated from waist circumference (WC) and triglyceride (TG) levels. The aim of this study was to elucidate the relationship between LAP and cardiovascular mortality as well as the presence of type 2 diabetes with respect to gender‐specific differences. We determined WC and fasting TG levels and the cardiovascular and metabolic phenotypes coronary artery disease (CAD), hypertension, metabolic syndrome, and diabetes mellitus in 2,279 men and 875 postmenopausal women who were routinely referred to coronary angiography. The LAP was calculated as (WC (cm) — 65) × (TG (mmol/l)) for men and as (WC (cm) — 58) × (TG (mmol/l)) for women. LAP levels were independently associated with congestive heart failure mortality in all postmenopausal women and with all‐cause mortality in diabetic postmenopausal women but not in men. Multivariable‐adjusted hazard ratios (with 95% confidence intervals) for all‐cause, cardiovascular, and congestive heart failure mortality in the third compared to the first LAP tertile were 4.28 (1.94–9.44; P < 0.001), 3.47 (1.28–9.40; P = 0.015), and 10.77 (1.21–95.88; P = 0.033), respectively, in normal weight postmenopausal women, whereas no significant associations were found in men. LAP levels were highly associated with type 2 diabetes in all subjects, postmenopausal women, and men. High LAP values are predictive of mortality independently of other cardiovascular risk factors in normal weight and diabetic postmenopausal women but not in men. Type 2 diabetes (T2DM) was highly associated with LAP in women and men. Our study validates an inexpensive and simple risk profiling that may allow identifying postmenopausal women at high cardiovascular risk.

A Strong Association between Lipid Accumulation Product and Diabetes Mellitus in Japanese Women and Men

“…The mean level of each variable was compared between women strated to be a better discriminator of diabetes than the body mass index, a general indicator of obesity 5,6) . The LAP has been shown to be associated with the risk of cardiovascular events 4,7) and to predict all-cause mortality in non-diabetic patients at high risk of cardiovascular disease 8) . However, the cutoff value for LAP has not been established, and analyses of LAP in previous studies were performed using tertile or quartile groups of LAP [4][5][6][7][8] .…”

“…The LAP has been shown to be associated with the risk of cardiovascular events 4,7) and to predict all-cause mortality in non-diabetic patients at high risk of cardiovascular disease 8) . However, the cutoff value for LAP has not been established, and analyses of LAP in previous studies were performed using tertile or quartile groups of LAP [4][5][6][7][8] . The aim of this concise study was to determine the cutoff value for a high LAP for discriminating hyperglycemia and diabetes and to evaluate the usefulness of LAP.…”

“…The LAP has been shown to be a good discriminator of diabetes and cardiovascular disease [4][5][6][7]20) . The present study, for the first time, reported the prevalence of a high LAP in the general population: approximately one-fourth of middle-aged Japanese women and men exhibited a high level of LAP, as defined using the proposed cutoff values.…”

Influence of a positive family history of both type 2 diabetes and PCOS on metabolic and endocrine parameters in a large cohort of PCOS women

“…There is accumulating evidence suggesting that central obesity is the key factor in the development of metabolic and cardiovascular risk in PCOS women (7,8,9). In this context, several indices such as lipid accumulation product (LAP) (8,10) and visceral adiposity index (VAI) (11) have been shown to be associated with an increased risk of insulin resistance, prediabetes and type 2 diabetes mellitus (T2DM) in PCOS as well as in other cohorts. Further, there is evidence showing that a positive family history (FHx) of T2DM, as a reflection of genetic risk, is associated with an increased risk of the development of T2DM in PCOS women (12,13,14).…”

Differences between Adiposity Indicators for Predicting All-Cause Mortality in a Representative Sample of United States Non-Elderly Adults

“…The LAP indicator extends this concept in the form of a continuous variable. Increased values of LAP have been associated with prevalent type 2 diabetes [11][12][13], incident type 2 diabetes [12,14], hepatic steatosis [15], and insulin resistance [16]. For this calculation we used the formulas:…”