1
|
Sadafi S, Azizi A, Najafi F, Pasdar Y. Lipid accumulation product and type 2 diabetes risk: a population-based study. BMC Endocr Disord 2024; 24:147. [PMID: 39134995 PMCID: PMC11318136 DOI: 10.1186/s12902-024-01682-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 08/07/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND The Lipid Accumulation Product (LAP) is a measure that indicates excessive fat accumulation in the body. LAP has been the focus of research in epidemiological studies aimed at forecasting chronic and metabolic diseases. This study aimed to evaluate the association between LAP and type 2 diabetes mellitus (T2DM) among adults in western Iran. METHODS The study involved 9,065 adults who participated in the initial phase of the Ravansar non-communicable diseases study (RaNCD) cohort. To investigate the association between LAP and T2DM, multiple logistic regressions were employed. Additionally, the receiver operating characteristic (ROC) curve was used to evaluate LAP's predictive ability concerning T2DM. RESULTS The participants had an average age of 47.24 ± 8.27 years, comprising 49.30% men and 50.70% women. The mean LAP was 53.10 ± 36.60 for the healthy group and 75.51 ± 51.34 for the diabetic group (P < 0.001). The multiple regression analysis revealed that the odds of T2DM in the second quartile of LAP were 1.69 (95% CI: 1.25, 2.29) times greater than in the first quartile. Furthermore, the odds in the third and fourth quartiles were 2.67 (95% CI: 2.01, 3.55) and 3.73 (95% CI: 2.83, 4.92) times higher, respectively. The ROC analysis for predicting T2DM showed that the LAP index had an area under the curve (AUC) of 0.66 (95% CI: 0.64, 0.68). CONCLUSION A strong association was identified between elevated LAP levels and T2DM in the adult population of western Iran. LAP is recommended as a potential tool for screening diabetes susceptibility.
Collapse
Affiliation(s)
- Sepehr Sadafi
- Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Azizi
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
- Department of Community and Family Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
2
|
Shu L, Zhang J, Jia L, Wang J, Han Z. Effect of lipid accumulation product on the development of hypertension among nondiabetic individuals in eastern China: A cross-sectional study. J Clin Hypertens (Greenwich) 2023; 25:784-793. [PMID: 37433158 PMCID: PMC10423760 DOI: 10.1111/jch.14696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/13/2023] [Accepted: 06/25/2023] [Indexed: 07/13/2023]
Abstract
This study was aimed at assessing the risk factors for hypertension (HTN) and prehypertension (PHT) in order to clarify the role of lipid accumulation product (LAP) in the development of HTN among nondiabetic individuals. A large cross-sectional study was conducted in community health service centers in urban Bengbu, Anhui Province, China. All participants completed an interview questionnaire and procedures to obtain physical measurements and biochemical indicators. Multivariate logistic regression was used to test for the prevalence of HTN and PHT in relation to each quartile increase in LAP level and family history of HTN. The resulting interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI). A total of 7733 subjects were enrolled in the study. The overall prevalence rates of PHT and HTN were 37.1% and 24.8%, respectively. After adjusting for confounding factors, multinomial logistic regression analysis showed that compared with subjects in LAP quartile 1, those in quartile 3 (OR, 1.257; 95% CI, 1.062-1.494) and quartile 4 (OR, 1.323; 95% CI, 1.101-1.592) had a significantly higher risk for HTN (p for trend < .001). A significant interaction was observed between LAP and family history of HTN in men (AP, 0.1661; 95% CI, 0.0024-0.3296; SI, 1.4037; 95% CI, 1.0599-1.8593) and in women (RERI, 1.4111; 95% CI, 0.1458-2.9678; AP, 0.1662; 95% CI, 0.0085-0.3237; SI, 1.3886; 95% CI, 1.0568-1.8247). The results demonstrated that the interactive effects of LAP with family history of HTN may influence the development of HTN synergistically.
Collapse
Affiliation(s)
- Li Shu
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Jiaye Zhang
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Linlin Jia
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Jinchen Wang
- School of public healthBengbu medical collegeBengbuAnhuiChina
| | - Ziyan Han
- School of public healthBengbu medical collegeBengbuAnhuiChina
| |
Collapse
|
3
|
Gu H, Hao L, Li M, Li J. Joint effect of overweight/obesity and tobacco exposure on hypertension in children aged 6-17 years: a cross-sectional study. Front Pediatr 2023; 11:1188417. [PMID: 37456569 PMCID: PMC10347524 DOI: 10.3389/fped.2023.1188417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/14/2023] [Indexed: 07/18/2023] Open
Abstract
Aim To assess the individual effects of overweight/obesity and tobacco exposure, and their combined effects on hypertension in children. Methods This cross-sectional study included 6,339 children aged 6-17 years from National Health and Nutrition Examination Surveys 1999-2018. Participants' height, weight and blood pressure (BP) were measured by trained technicians. Hypertension was defined as: mean systolic BP (SBP) and/or diastolic BP (DBP) ≥ 90th percentile for sex, age, and height (for children aged 1-13 years), and SBP ≥120 mmHg and/or a DBP ≥80 mmHg (for adolescents aged 13-17 years); or self-reported having been diagnosed with hypertension or taking antihypertensive medication. Gender- and age-specific body mass index (BMI) cut-points were used to define overweight/obesity: "overweight" was defined as a BMI > 1 standard deviation (SD); "obesity" was defined as BMI > 2SD; and "thinness" was defined as BMI < -2SD. Tobacco exposure was defined as having serum cotinine levels >0.05 µg/L or reporting the presence of at least one smoker in the household. Weighted univariate and multivariate logistic regression models were used to assess overweight/obesity and tobacco exposure with the odds of hypertension, and the combined effects of overweight/ obesity and tobacco exposure on hypertension, followed by strata-specific analyses. Odds ratios (OR) with 95% confidence intervals (CI) were calculated. Results The prevalence of overweight/obesity and tobacco exposure was significantly higher in the hypertension group than in the non-hypertension group. Overweight/obesity (OR = 1.67, 95%CI: 1.26-2.21/ OR = 2.38, 95%CI: 1.67-3.39) and tobacco exposure (OR = 1.58, 95%CI: 1.16-2.14) were associated with a higher odd of hypertension in children, respectively. Additionally, we also observed the combined effect between overweight (OR = 3.05, 95%CI: 1.96-4.75)/obesity (OR = 3.68, 95%CI: 2.24-6.03) and tobacco exposure were related to hypertension odds in children, with a significant effect in different populations. Conclusion There may exist joint effect of overweight/obesity and tobacco exposure on the odds of hypertension in American children. These findings offer an insight that early weight control and reduction of tobacco exposure may be important to reduce odds of hypertension in children.
Collapse
Affiliation(s)
- Huan Gu
- Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China
| | - Long Hao
- Department of Pediatrics, Beijing Fangshan District Liangxiang Hospital, Beijing, China
| | - Mingxi Li
- Department of Pediatrics, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ji Li
- Department of Pediatrics, Guang’ Anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
4
|
Chen ZY, Liu L, Zhuang XX, Zhang YC, Ma YN, Liu Y, Wen DL. Lipid accumulation product is a better predictor of metabolic syndrome in Chinese adolescents: a cross-sectional study. Front Endocrinol (Lausanne) 2023; 14:1179990. [PMID: 37424867 PMCID: PMC10326626 DOI: 10.3389/fendo.2023.1179990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/09/2023] [Indexed: 07/11/2023] Open
Abstract
Aim Confirm and compare the degree of associations of non-traditional lipid profiles and metabolic syndrome (MetS) in Chinese adolescents, determine the lipid parameter with better predictive potential, and investigate their discriminatory power on MetS. Methods Medical measurements, including anthropometric measurements and biochemical blood tests, were undergone among a total sample of 1112 adolescents (564 boys and 548 girls) aged from 13 to 18 years. Univariate and multivariate logistic regression analyses were applied for assessing the relationships between the levels of traditional/non-traditional lipid profiles and MetS. We performed Receiver Operating Characteristic (ROC) analyses to mensurate the effectiveness of lipid accumulation product (LAP) on the diagnosis of MetS. Meanwhile, areas under the ROC curve and the cut-off values were calculated for MetS and its components. Results Univariate analysis showed that all our lipid profiles were closely associated with MetS (P< 0.05). LAP index showed the closest association with MetS than the other lipid profiles. Additionally, ROC analyses indicated that the LAP index showed sufficient capabilities to identify adolescents with MetS and its components. Conclusion The LAP index is a simple and efficient tool to identify individuals with MetS in Chinese adolescents.
Collapse
Affiliation(s)
- Zi-yi Chen
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning, China
| | - Lei Liu
- School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
| | - Xu-xiu Zhuang
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning, China
| | - Yi-cong Zhang
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning, China
| | - Ya-nan Ma
- School of Public Health, China Medical University, Shenyang, Liaoning, China
| | - Yang Liu
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning, China
| | - De-liang Wen
- Institute of Health Sciences, China Medical University, Shenyang, Liaoning, China
| |
Collapse
|
5
|
Dos Santos Sena B, da Silva Pastich Gonçalves FCL, Maio R, Silva RPP, da Conceição Chaves de Lemos M, de Arruda IKG. Visceral adiposity indices and cardiometabolic risk markers in patients with hypertension. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:224-232. [PMID: 36468922 PMCID: PMC10689027 DOI: 10.20945/2359-3997000000536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/05/2022] [Indexed: 12/12/2022]
Abstract
Objective Arterial hypertension (AH) is a risk factor for cardiovascular diseases (CVD). We sought to evaluate the association between two adiposity indices (visceral adiposity index [VAI] and lipid accumulation product [LAP]) with traditional markers of cardiometabolic risk in hypertensive patients. Materials and methods This is a cross-sectional study with 1,273 subjects with hypertension treated as outpatients at a university hospital. The VAI and LAP were calculated using formulas stratified by sex. Cardiometabolic risk variables were considered: overweight, risk for waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHA), and altered biochemical test values. The predictive effect of independent variables on outcomes was assessed by multivariate linear regression analysis. There was statistical significance when p ≤ 0.05. Results Higher cardiometabolic risk (according to BMI, WHR, WHA, and altered biochemical parameters) was associated with higher values of VAI and LAP with statistical significance (p ≤ 0.05). The regression models used explained 30.7% and 10.5% of the changes in LAP and VAI, respectively. Conclusion LAP and VAI are associated with cardiometabolic risk parameters in the individuals evaluated, suggesting that these indices can be used to screen for CVD risk in individuals with AH.
Collapse
Affiliation(s)
| | | | - Regiane Maio
- Departamento de Nutrição, Universidade Federal de Pernambuco, Recife, PE, Brasil
| | | | | | | |
Collapse
|
6
|
Ren Y, Tong E, Di C, Zhang Y, Xu L, Tan X, Yang L. Association Between ABCA1 Gene Polymorphisms and the Risk of Hypertension in the Chinese Han Population. Front Public Health 2022; 10:878610. [PMID: 35669754 PMCID: PMC9163321 DOI: 10.3389/fpubh.2022.878610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022] Open
Abstract
Background Hypertension is rising as a major public health burden around the world. This study explored the association between single-nucleotide polymorphisms (SNPs) in the adenosine triphosphate (ATP)-Binding Cassette Subfamily A1 (ABCA1) gene and hypertension among Chinese Han adults. Method A total of 2,296 Han Chinese in southeast China were recruited for this study. We collected medical reports, lifestyle details, and blood samples from individuals. The polymerase chain reaction-ligase detection reaction (PCR-LDR) method was used to detect the genotypes of these SNPs in the ABCA1 gene. Results After adjusting some covariates, the additive and recessive models of the rs2472510 and rs2515614 were significantly associated with hypertension. The haplotypes TCTA (rs2297406-rs2472433-rs2472510-rs2515614) were associated with high SBP, and the haplotypes CCTA, TCTA, and TTTA were associated with high diastolic blood pressure (DBP). Conclusion The results of the relationship between the polymorphisms of rs2297406, rs2472433, rs2472510, and rs2515614 in ABCA1 and hypertension in southeastern China would provide a theoretical basis for genetic screening and disease prevention.
Collapse
Affiliation(s)
- Yanli Ren
- Medical School, Hangzhou Normal University, Hangzhou, China
| | - Enyu Tong
- Medical School, Hangzhou Normal University, Hangzhou, China
| | - Chunhong Di
- Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
| | - Yunheng Zhang
- Medical School, Hangzhou Normal University, Hangzhou, China
| | - Liangwen Xu
- Medical School, Hangzhou Normal University, Hangzhou, China
| | - Xiaohua Tan
- Medical School, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Xiaohua Tan
| | - Lei Yang
- Medical School, Hangzhou Normal University, Hangzhou, China
- Lei Yang
| |
Collapse
|
7
|
Zhang Z, Zhang L, Sun L, Wang B, Yuan Y, Gao H, Fu L. Relative children's lipid accumulation with hypertension in Chinese children and adolescents. BMC Public Health 2021; 21:1884. [PMID: 34663277 PMCID: PMC8524786 DOI: 10.1186/s12889-021-11868-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 09/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background This study aimed to develop a novel indicator associated with hypertension in Chinese children and adolescents, the relative children’s lipid accumulation product (RCLAP). Methods A cross-sectional study was conducted in 2018. A total of 683 students aged 8–15 years were recruited via a stratified cluster sampling Methods. Anthropometric indexes (waist circumference (WC), Body mass index (BMI), Waist-height ratio (WHtR), logarithm children LAP (LnCLAP), RCLAP per height (RCLAP-H)) were standardized using a z-score method (standardized variables: SWC, SBMI, SWHtR, SLnCLAP, SRCLAP-H). A logistic regression model was performed to evaluate the association of the above indicators with the outcome of hypertension. Results The overall prevalence of hypertension was 5.7% (5.5% in boys, 6.0% in girls). SWC ≥ P75, SBMI ≥ P75, SWHtR ≥ P75, SlnCLAP ≥ P75 and SRCLAP-H ≥ P75 significantly increased risk of hypertension, with odds ratios (OR) of 2.21 (95% confidence interval (CI): 1.13, 4.30), 2.30 (1.18, 4.49), 2.64 (1.35, 5.14), 4.43 (2.28, 8.61), and 4.49 (2.31, 8.71), respectively. Conclusion RCLAP is a novel indicator associated with hypertension in Chinese children and adolescents, and it performs better than WC, BMI, WHtR and children LAP.
Collapse
Affiliation(s)
- Zizhe Zhang
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China
| | - Li Zhang
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China
| | - Lili Sun
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China
| | - Bangxuan Wang
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China
| | - Yongting Yuan
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China
| | - Huaiquan Gao
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China.
| | - Lianguo Fu
- Department of child and adolescent health, School of public health, Bengbu Medical College, No. 2600 east sea avenue, Room 207, Bengbu, 233030, Anhui, China.
| |
Collapse
|
8
|
Hassan NE, El-Masry SA, El-Saeed GSM, El Hussieny MS. Lipid Accumulation Product as an Index for Visceral Obesity and Cardiovascular Risk among a Sample of Obese Egyptian Women. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background:Lipid accumulation product (LAP) is one of the indices that can demonstrate cardiovascularrisk factors according to international studies. Aim: To evaluate relationship between LAP, visceral obesity and different cardio vascular risk factors among sample of obese Egyptian Women. Methods: A retrospective cross-sectional observational study included 350 obese Egyptian women; aged 25- 55 years. They were subjected to blood pressure and anthropometric assessment (weight, height and waist circumference), abdominal ultrasound (visceral fat) and laboratory tests (fasting blood sugar and lipid profile).Results: The majority of the participated women had wide WC (88.9%) and increased visceral fat (80.6%). Hyperglycemia was present among (47.4%), hypertension among 42.6%, high triglycerides among 26.6% and low HDL among 44.3%. The odds of obtaining LAP >80.74 cm.mmol/L (4th quartile) is 2.7 times higher in individuals with hypertension(BP > 130/85),and 6.79 times higher in individuals with visceral fat ≥ 5 cm. Depending on the visceral fat as a standard for classification of visceral obesity (>5 cm for women), revealed that the AUCs of LAP was 0.752 (95% CI 0.697–0.806) in women. The cutoff point of LAP;for prediction of visceral obesity among Egyptian women, was 61.69; using ROC analysis; with sensitivity 68% and specificity 75% and PPV/NPV 1.05 and accuracy 71.5% .Conclusion: LAP index had significant correlations with visceral obesity and hypertension. The cutoff point of LAP 61.69 can be used to predict visceral obesity among Egyptian women.
Collapse
|
9
|
Age-adjusted cut-off values of lipid accumulation product (LAP) for predicting hypertension. Sci Rep 2021; 11:11095. [PMID: 34045594 PMCID: PMC8159997 DOI: 10.1038/s41598-021-90648-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/05/2021] [Indexed: 01/11/2023] Open
Abstract
Among the many factors considered relevant to hypertension, obesity and metabolic disturbances play an important role in the development of this pathology. Therefore, lipid accumulation product (LAP), an index of visceral adiposity, is a simple and effective indicator of hypertension risk. To date, the reference and cut-off values for LAP have not been defined. The aim of the study was to determine the age-adjusted optimal cut-off values of LAP for the prediction of hypertension risk. This cross-sectional case–control study comprised 1960 subjects ranging from 20 to 64 years of age. The participants underwent anthropometric tests, blood pressure measurements, questionnaire surveys and laboratory examinations. The cut-off values of LAP were determined using receiver operating characteristic (ROC) curve analysis. According to our study results, LAP values in healthy subjects increased with age, whereas there was no effect of age on LAP values in patients with hypertension. These two findings determine the presence of age-adjusted cut-off values of LAP for diagnosing hypertension. Increasing age is associated with an increase in the cut-off values of LAP to detect hypertension. In conclusion, hypertension risk should be estimated using the age-adjusted cut-off values of LAP; otherwise, the risk of hypertension might be overestimated or underestimated.
Collapse
|
10
|
Yu P, Huang T, Hu S, Yu X. Predictive value of relative fat mass algorithm for incident hypertension: a 6-year prospective study in Chinese population. BMJ Open 2020; 10:e038420. [PMID: 33067286 PMCID: PMC7569915 DOI: 10.1136/bmjopen-2020-038420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Individuals with obesity especially excessive visceral adiposity have high risk for incident hypertension. Recently, a new algorithm named relative fat mass (RFM) was introduced to define obesity. Our aim was to investigate whether it can predict hypertension in Chinese population and to compare its predictive power with traditional indices including body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). DESIGN A 6-year prospective study. SETTING Nine provinces (Hei Long Jiang, Liao Ning, Jiang Su, Shan Dong, He Nan, Hu Bei, Hu Nan, Guang Xi and Gui Zhou) in China. PARTICIPANTS Those without hypertension in 2009 survey and respond in 2015 survey. INTERVENTION Logistic regression were performed to investigate the association between RFM and incident hypertension. Receiver operating characteristic (ROC) analysis was performed to compare the predictive ability of these indices and define their optimal cut-off values. MAIN OUTCOME MEASURES Incident hypertension in 2015. RESULTS The prevalence of incident hypertension in 2015 based on RFM quartiles were 14.8%, 21.2%, 26.8% and 35.2%, respectively (p for trend <0.001). In overall population, the OR for the highest quartile compared with the lowest quartile for RFM was 2.032 (1.567-2.634) in the fully adjusted model. In ROC analysis, RFM and WHtR had the highest area under the curve (AUC) value in both sexes but did not show statistical significance when compared with AUC value of BMI and WC in men and AUC value of WC in women. The performance of the prediction model based on RFM was comparable to that of BMI, WC or WHtR. CONCLUSIONS RFM can be a powerful indictor for predicting incident hypertension in Chinese population, but it does not show superiority over BMI, WC and WHtR in predictive power.
Collapse
Affiliation(s)
- Peng Yu
- Department of Internal Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Teng Huang
- Department of Internal Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Senlin Hu
- Department of Internal Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xuefeng Yu
- Department of Internal Medicine, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
11
|
Huang J, Bao X, Xie Y, Zhang X, Peng X, Liu Y, Cheng M, Ma J, Wang P. Interaction of lipid accumulation product and family history of hypertension on hypertension risk: a cross-sectional study in the Southern Chinese population. BMJ Open 2019; 9:e029253. [PMID: 31784431 PMCID: PMC6924775 DOI: 10.1136/bmjopen-2019-029253] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES This study aimed at investigating the applicability of a novel index based on waist circumference (WC) and triglyceride (TG) which was named lipid accumulation product (LAP) in the Southern Chinese population, and compared the predictive effects of LAP and other obesity indicators on hypertension risk. Moreover, this study investigated the interactive effects of LAP and family history of hypertension. METHODS A total number of 2079 of community-dwelling adults in Southern China were enrolled in this cross-sectional study. The participants underwent questionnaire surveys, anthropometric tests and laboratory examinations. Themultinomial logistic regression model and receiver operating characteristic curves, including LAP, body mass index (BMI), waist-to-hip ratio (WHR), WC and TG, were used to assess the association between hypertension risk and obesity indexes. The interaction effects were evaluated by relative excess risk of interaction (RERI), attributable proportion due to interaction (AP) and synergy index (SI). RESULTS Higher LAP levels have a relatively higher risk of having hypertension in both sexes (males: adjusted OR=2.79 per SD increase, 95% CI 1.43 to 5.44, p<0.001; females: adjusted OR=3.15, 95% CI 1.56 to 6.39, p<0.001). LAP (area under the curve=0.721; 95% CI 0.680 to 0.761) is a better indicator in identifying hypertension risk than BMI, WHR and TG in females, but WC performed better in males. A significant interaction between LAP and family history of hypertension was observed in males (RERI=1.652, 95% CI 0.267 to 3.037; AP=0.516, 95% CI 0.238 to 0.794; SI=3.998, 95% CI 0.897 to 17.820), but there is no statistically significant difference in females. CONCLUSIONS LAP significantly associates with hypertension risk in the Southern Chinese population. It has better performance than BMI, WHR and TG on predicting hypertension risk of the Southern Chinese female population. Moreover, LAP and family history of hypertension might synergistically increase the risk of hypertension.
Collapse
Affiliation(s)
- JunXuan Huang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
- General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, China
| | - XinYu Bao
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - YiXian Xie
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - XiaoXia Zhang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Xin Peng
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yan Liu
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - MengJiao Cheng
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - JinXiang Ma
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - PeiXi Wang
- General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, China
| |
Collapse
|
12
|
Yan G, Li F, Elia C, Zhao Y, Wang J, Chen Z, Yuan H, Lu Y. Association of lipid accumulation product trajectories with 5-year incidence of type 2 diabetes in Chinese adults: a cohort study. Nutr Metab (Lond) 2019; 16:72. [PMID: 31641369 PMCID: PMC6802349 DOI: 10.1186/s12986-019-0399-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/24/2019] [Indexed: 12/12/2022] Open
Abstract
Background Lipid accumulation product (LAP) is an index describing the overaccumulation of lipid. Baseline LAP was used for type 2 diabetes (T2D) prediction in previous studies. But the longitudinal trajectories of LAP, which reflect the efficacy of patients' lipid-lowering treatment and lifestyle improvement, have rarely been studied. The aim of this study is to explore the association of lipid accumulation product trajectories with 5-year incidence of type 2 diabetes. Methods This cohort study included 4508 non-diabetic participants with a median age of 42 years. Using the group-based trajectory modeling (GBTM), LAP from 2011 to 2016 were determined and identified as three trajectories: low (n = 3639), moderate (n = 800), and high (n = 69). Baseline LAP was divided into groups by percentiles and tertiles respectively for the comparison of LAP trajectories. The associations between 5-year T2D incidence and LAP trajectories and baseline LAP were both assessed by generalized linear models. Results From 2011 to 2016, 169 participants developed T2D (the 5-year incidence of 3.8%). For participants with low, moderate, and high trajectories, the incidence of T2D was 2.1, 10.0, and 15.9%, respectively. A significant trend was observed in the relative risks (RRs) of 5-year incident T2D in participants with moderate (RR, 1.95; 95% CI: 1.41-2.70) and high LAP trajectory (RR, 2.20; 95% CI: 1.12-4.30) in the fully adjusted model (p for trend< 0.001). However, there were no statically significant trends in RRs in different tertiles of baseline LAP found after full adjustments. Conclusion The trajectories of LAP has an independent effect on 5-year T2D incidence beyond LAP measured at baseline.
Collapse
Affiliation(s)
- Guangyu Yan
- 1Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Fei Li
- 1Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Christelle Elia
- 2Department of Life Science and Medicine, King's College London, WC2R 2LS, London, UK
| | - Yating Zhao
- 3Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Jiangguang Wang
- 3Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Zhiheng Chen
- 3Health Management Center, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Hong Yuan
- 1Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China
| | - Yao Lu
- 1Center of Clinical Pharmacology, The Third Xiangya Hospital, Central South University, 138 Tongzipo Road, Changsha, Hunan 410013 People's Republic of China.,2Department of Life Science and Medicine, King's College London, WC2R 2LS, London, UK
| |
Collapse
|
13
|
Nguyen Ngoc H, Kriengsinyos W, Rojroongwasinkul N, Aekplakorn W. Association of Adiposity Indices with Hypertension in Middle-Aged and Elderly Thai Population: National Health Examination Survey 2009 (NHES-IV). J Cardiovasc Dev Dis 2019; 6:E13. [PMID: 30871270 PMCID: PMC6463150 DOI: 10.3390/jcdd6010013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/19/2019] [Accepted: 03/08/2019] [Indexed: 12/11/2022] Open
Abstract
Obesity in terms of excess fat mass is associated with increased morbidity, disability and mortality due to obesity-related disorders, including hypertension. Many hypertensive individuals are overweight and often receive their advice to lose weight related to body-fat, in order to lower their blood pressure. However, it is still unclear whether there is a strong association of adipose tissue measured by adiposity indicators with hypertension in the Thai population. Various adiposity indices have been published to distinguish the distribution of body fat with disparate properties. This study examined nine adiposity markers and their association with hypertension in 15,842 Thai adults ≥35 years old. Data were obtained from the nationwide Thai National Health Examination Survey 2009. Accuracy performance and associations of indexes with hypertension were analyzed by Area Under Curve (AUC) and logistic regression analyses. Regardless of gender, the best methods to distinguish performance were waist-to-height ratio (WHtR) [AUC: 0.640 (0.631⁻0.649)], followed by lipid accumulation product (LAP) [AUC: 0.636 (0.627⁻0.645)], waist circumference (WC) [AUC: 0.633 (0.624⁻0.641)], and Conicity index (C-Index) [AUC: 0.630 (0.621⁻0.639)]. Linear regression analysis exhibited the independent association of the top four indices, WC, WHtR, C-Index, and LAP with higher systolic and diastolic blood pressure. Those indices' quartiles were graded in a dose-response manner which significantly increased at the higher quartiles. The indicator's cutoff point carried the odds ratio of presence hypertension in the range of 1.7 to 2.5 (p < 0.001). Among the nine obesity indices, WHtR (cutoff >0.52) in both genders was the simplest and most practical measurement for adiposity in association with hypertension in middle-aged and elderly Thais.
Collapse
Affiliation(s)
- Hung Nguyen Ngoc
- Institute of Nutrition, Mahidol University, Nakhon Pathom 73170, Thailand.
| | | | | | - Wichai Aekplakorn
- Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
| |
Collapse
|
14
|
Song J, Chen X, Jiang Y, Mi J, Zhang Y, Zhao Y, Wu X, Gao H. Association and Interaction Analysis of Lipid Accumulation Product with Impaired Fasting Glucose Risk: A Cross-Sectional Survey. J Diabetes Res 2019; 2019:9014698. [PMID: 31772946 PMCID: PMC6854969 DOI: 10.1155/2019/9014698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/25/2019] [Accepted: 10/01/2019] [Indexed: 12/11/2022] Open
Abstract
AIMS Lipid accumulation product (LAP) is put forward as a powerful marker showing the accumulation of visceral fat. The present study is aimed at (i) analyzing the predictive performances of LAP in the identification of impaired fasting glucose (IFG) in Chinese population and (ii) exploring the potentially interactive effect between LAP and other factors on IFG risk. METHODS Analysis was conducted on the data obtained from a community-based cross-sectional survey in Chinese population, and all the participants enrolled were required to complete a face-to-face questionnaire survey and related health checks. Then, for the purpose of comparing predictive values between LAP and conventional obesity indices for IFG, relevant analysis was carried out on the receiver operating characteristic (ROC) curve. The assessment of interactive effects was conducted by employing the three indicators as follows: (1) RERI (the relative excess risk due to interaction), (2) AP (attributable proportion due to interaction), and (3) SI (synergy index). RESULTS A total of 1777 participants (748 males and 1029 females) were involved in the final analysis. It was finally obtained that the prevalence rate of IFG was 14.1% in total, 15.5% for males and 13.1% for females, respectively. In logistic regression analysis, individuals with LAP levels in the fourth quartile had a significant higher risk of getting IFG in comparison with that of the lowest quartile (crude OR: 4.58, 95% CI: 3.01-6.98; adjusted OR: 3.81, 95% CI: 2.33-6.23). In addition, it was indicated by the ROC curve analysis that LAP showed a better performance in discriminating IFG risk than BMI in both males (Z = 2.20, P = 0.028) and females (Z = 2.13, P = 0.033). However, LAP displayed a higher predictability in comparison with WC only in females (Z = 2.07, P = 0.038), but not in males (Z = 0.18, P = 0.860). Furthermore, LAP and family history of diabetes were able to impose significant synergistic interaction on the risk of IFG, which was indicated by all the parameters in females (RERI: 2.52, 95% CI: 0.19-4.84; AP: 0.47, 95% CI: 0.20-0.74; SI: 2.39, 95% CI: 1.17-4.87) and males (RERI: 2.18, 95% CI: 0.08-4.73; AP: 0.43, 95% CI: 0.07-0.79; SI: 2.15, 95% CI: 1.03-5.45). However, none of the indicators showed significant interaction between LAP and smoking on the risk of IFG in females (RERI: 0.92, 95% CI: -2.79-4.63; AP: 0.20, 95% CI: -0.50-0.92; SI: 1.37, 95% CI: 0.42-4.52). Meanwhile, there was also no significant interaction between LAP and smoking on the risk of IFG in males as indicated by the value of SI (2.22, 95% CI: 0.80-6.21). CONCLUSION It was concluded that LAP was significantly related to a higher risk of IFG in Chinese population, and its performance was superior to that of conventional obesity indices, especially in females. Apart from that, LAP with family history of diabetes may have an interactive effect that can impose a great influence on the development of IFG.
Collapse
Affiliation(s)
- Jian Song
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Xue Chen
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Yuhong Jiang
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Jing Mi
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Yuyuan Zhang
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Yingying Zhao
- Bengbu Health Board, 568 Nanhu Road, Bengbu, 233000 Anhui Province, China
| | - Xuesen Wu
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| | - Huaiquan Gao
- School of Public Health, Bengbu Medical College, 2600 Donghai Road, Bengbu, 233000 Anhui Province, China
| |
Collapse
|