Lipid accumulation product and incident cardiovascular events in a normal weight population: Tehran Lipid and Glucose Study

Abstract

Background The lipid accumulation product (LAP) is a relatively new marker for measuring cardiovascular disease (CVD) risk factors. We investigated predictability of LAP value for incident CVD among Tehranian adults with normal BMI. Methods A population based cohort of subjects without history of prevalent cardiovascular disease, aged ≥30 years who had BMI <25 were followed for a median (interquartile range 25-75) of 10.1 (7.25-10.57) years. Subjects were stratified according to LAP tertiles. LAP was defined as WC-58 × TG for women and WC-65 × TG for men (where WC is waist circumference and TG is triglycerides). Cox regression analyses were used to estimate the hazard ratio (HR) of CVD events; c-statistics test was also calculated to compare LAP with other anthropometric indices. Result In this prospective study of 2378 subjects (57.0% men) with mean age of 46.1 ± 13.5 years, and mean BMI 22.59 ± 1.9 kg/m2 an increasing trend of cardiovascular risk factors along LAP tertiles (except for smoking and history of premature CVD events) was observed. During follow-up 160 CVD cases occurred (incidence rates (per 1000 person-years) of CVD across LAP tertiles were 4.14 (2.88-5.96), 6.82 (5.13-9.04) and 12.37 (9.97-15.34), respectively). Adjusted HRs for development of cardiovascular disease across LAP tertiles were 1.56 (95% confidence interval (CI) =0.91-2.69) and 2.17 (95% CI = 1.22-3.86) respectively. C-statistics of LAP were not significantly higher than other anthropometric measures for predicting incident CVD. Conclusion LAP is an independent predictor of cardiovascular events in normal BMI subjects, but is not superior over other anthropometrics indices.