Study Identifies Lipid Accumulation Product as Strongest Predictor of Diabetes Risk in Visceral Obesity
China: A new prospective cohort study from China has provided fresh insights into the link between visceral obesity and the future risk of developing diabetes mellitus (DM). Conducted by Dr. Yue Zhang and colleagues from the People's Liberation Army Medical School in Beijing, the research highlights the clinical significance of various visceral fat markers and positions the Lipid Accumulation Product (LAP) as the most powerful predictor of diabetes onset.
Published in Diabetes, Obesity and Metabolism, the study involved 6,575 participants aged 40 years and older who were free from diabetes at the beginning of the study. These individuals were followed over an average period of 3.19 years, during which their metabolic health was monitored. For the follow-up, 752 participants (11.4%) developed diabetes.
To assess the relationship between visceral fat and diabetes risk, the researchers examined five specific visceral obesity indices: waist-to-height ratio (WHtR), body roundness index (BRI), visceral adiposity index (VAI), abdominal body shape index (ABSI), and LAP. These indices were analyzed using multivariable-adjusted Cox proportional hazards models. Additionally, restricted cubic spline (RCS) models were used to evaluate dose-response relationships, and ROC curve analysis was conducted to assess the predictive accuracy of each index.
Key findings from the study include:
- All five visceral obesity indices were significantly associated with an elevated risk of developing diabetes, independent of other risk factors.
- LAP showed the strongest predictive value among all the indices assessed.
- The hazard ratio for LAP was 2.93, indicating that individuals with high LAP levels had nearly three times the risk of developing diabetes compared to those with lower values.
- RCS analysis revealed a nonlinear dose-response relationship between these indices and diabetes risk, suggesting a complex link between fat distribution and disease progression.
- Stratified and sensitivity analyses demonstrated the consistent predictive strength of LAP across various population subgroups.
- ROC curve analysis showed LAP had the highest predictive accuracy, with an area under the curve (AUC) of 0.752, reflecting a strong ability to identify high-risk individuals.
The study emphasizes the pivotal role of visceral fat in the pathogenesis of diabetes. It encourages healthcare professionals to consider visceral obesity indices, particularly LAP, when evaluating metabolic risk.
“The study reinforces the link between excess visceral fat and the onset of diabetes,” the authors noted. “It presents LAP as a simple and powerful tool for early identification of at-risk individuals, paving the way for more targeted prevention strategies to reduce visceral fat and mitigate the diabetes burden.”
Reference: https://doi.org/10.1111/dom.16492
