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

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/m(2) 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.