The value of lipid accumulation product index on screening carotid atherosclerosis in females in Dalian area / 中国医师进修杂志

ABSTRACT

Objective:To explore the relationship between the lipid accumulation product index (LAP) and the risk of carotid atherosclerosis in different gender groups.Methods:The data of 2 740 employees of Dalian municipal government and institutions, including 1 583 males and 1 157 females, who had underwent physical examination in Dalian Municipal Central Hospital Affiliated of Dalian Medical University from January to June 2018 were analyzed retrospectively. The general data, laboratory indexes and carotid ultrasound data of the population were collected, and the body mass index (BMI) and LAP value were calculated. According to carotid intima-media thickness (IMT), the subjects were divided into carotid atherosclerosis group (IMT ≥ 1.0 mm) and carotid normal group (IMT<1.0 mm). The clinical indicators between the two groups were compared. Independent risk factors for carotid atherosclerosis were analyzed by binary Logistic regression, and the cutoff point for predicting carotid atherosclerosis by LAP was calculated by receiver operating characteristic (ROC) curve.Results:The age, waist circumference (WC), hip circumference (HC), LAP, BMI, total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), fasting plasma glucose (FPG), systemic blood pressure (SBP), diastolic blood pressure (DBP) and the prevalence of hypertension and diabetes in the male and female population carotid atherosclerosis groups were significantly higher than those in the normal group ( P<0.05). The results of binary Logistic regression analysis showed that after adjusting age, BMI, HC, WC, smoking, drinking, hypertension, diabetes, TC and LDL-C, the risk of carotid arteriosclerosis still increased 1.316 times with each quartile interval of LAP in women ( OR= 1.316, 95% CI 1.063 to 1.629, P = 0.012). In men, after adjusting for these factors, the independent effect of LAP on the risk of carotid atherosclerosis disappeared. In women, the area under curve (AUC) of LAP in predicting carotid atherosclerosis was 0.713, significantly higher than that of BMI (AUC 0.614) and WC (AUC 0.654), and the differences were statistically significant ( P<0.05). But there was no significant difference among the three indexes in the male population in predicting carotid atherosclerosis. According to ROC curve, the best cut-off value of LAP for predicting carotid atherosclerosis was 32.13 cm·mmol/L in men and 33.70 cm·mmol/L in women. Conclusions:LAP is an independent risk factor for carotid atherosclerosis in female population, and its predictive ability for carotid atherosclerosis is higher than that of body mass index and waist circumference. LAP ≥ 33.70 cm·mmol/L can be used as the best cut-off value for screening carotid atherosclerosis in female population.