Lipid Accumulation Product (LAP) Is Associated with Subclinical Vascular Inflammation

Lipid accumulation product (LAP) is associated with subclinical vascular inflammation among without metabolic syndrome Omar Jamal, Ebenezer Oni, Lara Roberson, Kemi Adeyemo, Wasim Muzaik, Theodore Feldman, Michael J Blaha, Arthur A Agatston, Roger S Blumenthal, Jose A. Carvalho, Raquel D. Conceiçao, Romeu S. Meneghelo, Khurram Nasir, Raul D Santos BACKGROUND: Lipid accumulation product (LAP) is a simple indicator that requires only the determination of circulating triglycerides and measurement of waist circumference. It has been recently shown to strongly predictive metabolic syndrome and its associated risk. However little is known if LAP will have similar value among those without known MS. We aimed to investigate whether LAP is related to subclinical vascular inflammation among those with and without MS METHODS: We evaluated 6,457 healthy Brazilian subjects (43±10 years, 79% males) without clinical coronary heart disease between November 2008 and July 2010. LAP (waist-58 × triglycerides [nmol/L]) cutoff point of ≥34.5 was used. C-reactive protein ≥ 3mg/dl was used as a marker for subclinical vascular inflammation.

RESULTS: The prevalence of Crp ≥ 3mg/dl was 31% (n=2,007) and 3,322 (51%) had LAP index ≥ 34.5, (MS+ 96% vs MS- 40%, p<0.001). MS+ individuals were more likely to have elevated CRP, 38% vs. 29%, p<0.001 and Individuals with LAP index ≥34.5 had higher Crp, p<0.001. Among individuals without MS, elevated LAP was 1.75 times more likely to predict an elevated CRP level. Interestingly, no association was seen in the group with MS. The result of the unadjusted and adjusted regression model is presented in the table below.

CONCLUSIONS: In this cohort of asymptomatic individuals, there is a stronger association between the LAP index and systemic inflammation in persons without the metabolic syndrome. It may imply that the LAP index may be a useful tool in predicting subclinical CVD among individuals without metabolic syndrome. Future studies to ascertain the predictive value are important. Total MS(+) MS (-) Model 1 1.47(1.32-1.63)*** 0.80(0.46-1.39) 1.38(1.22-1.56)*** Model 2 1.56(1.27-1.58)*** 0.93(0.53-1.64) 1.47(1.29-1.67)*** Model 3 1.50(1.25-1.64)*** 0.94(0.52-1.70) 1.49(1.28-1.75)***

**p<0.005, ***p<0.001 Model 1: unadjusted Model 2: adjusted for age, gender Model 3: model 2 +SBP, fasting glucose, lipid lowering meds, diabetic meds, Ldl-C, Smoking, TG:HDL ratio,