| Objective:To explore the relationship between lipid accumulation product(LAP)and metabolic syndrome,diabetes,cardiovascular and cerebrovascular diseases.Methods:The baseline survey of this study used the data of metabolic syndrome survey in Zhejiang Province from 2009 to 2012 as baseline data,including epidemiological questionnaires,physical examinations and common biochemical tests.The subjects were 22649 permanent residents aged 18 and over.The first part of the follow-up survey used Zhejiang chronic disease monitoring information management system and record linkage method,to obtain information on the incidence of diabetes,cardiovascular and cerebrovascular diseases from baseline survey to 2018.There were 1411 residents with missing baseline data,biochemical data or physical data,and 1498 residents with baseline chronic disease were excluded.Finally,19740 subjects were included,8361males and 11379 females.The second part was repeated baseline survey(the incidence analysis of metabolic syndrome).From 2014 to 2018,6240 baseline subjects in Tongxiang,Shushi,Liuheng and Mayi Island were followed up.The effective number was 3868,of which 237 subjects were excluded with missing biochemical or physical data(including those who could not judge whether they suffered from metabolic syndrome),789 subjects were excluded with baseline metabolic syndrome and chronic diseases.Finally,2842 subjects were included,1124 males and 1718 females.The average follow-up time was 5.69 years.The subjects were divided into several groups according to the LAP quartile.The LAP first quintile(low level group)was used as reference to calculate the disease density.The Cox proportional hazard regression model was used to analyze the incidence risk of metabolic syndrome,diabetes,cardiovascular and cerebrovascular diseases between different LAP level groups.The ROC curve was used to compare the predictive value of LAP,body mass index(BMI)and waist circumference(WC)on the incidence risk of metabolic syndrome,diabetes and cardiovascular and cerebrovascular diseases.Result:The baseline survey of the population showed that the quartiles of LAP were 11.94,20.58 and 33.78.The average level of LAP in female was higher than that in male,and the difference was statistically significant(P<0.05).The subjects were divided into 4 groups according to the LAP quartile.Statistical analysis showed that the level of LAP was positively correlated with age,waist circumference,body mass index,systolic blood pressure,diastolic blood pressure,fasting blood glucose,total cholesterol and triglycerides(P<0.05).During the follow-up period,a total of 741 subjects developed metabolic syndrome,including 178 males and 563 females,the total incidence density is 45.76/1000 person-years.The density of metabolic syndrome in the first to fourth quintiles of LAP was 8.70/1000 person-years,30.98/1000 person-years,56.86/1000 person-years and 90.89/1000 person-years,respectively;a total of 445 subjects developed diabetes,of which there were 159 males and 286 females.The total incidence density was 3.29/1000 person-years.The incidence of diabetes in the first to fourth quintiles of LAP was 1.23/1000 person-years,1.99/1000 person-years,3.61/1000 person-years and 6.47/1000 person-years;a total of 666 subjects developed cardiovascular and cerebrovascular diseases,including 349 males and 317 females.The total incidence density was 4.86/1000 person-years.The first to fourth quintiles LAP group were 4.18/1000 person-years,4.82/1000 person-years,5.38/1000 person-years and 5.57/1000 person-years.With the increase of LAP level,the incidence of metabolic syndrome,diabetes,cardiovascular and cerebrovascular diseases increased.After controlling the factors of gender,age,smoking,drinking,labor intensity and family history,the results of Cox risk regression analysis showed that the first quintile of the LAP level(low level group)was used as a reference,the HR values of the second,third and forth quartile metabolic syndrome were 4.49(2.95,6.85),8.92(5.96,13.34),and 15.62(10.52,23.18),the HR values of diabetes risk were 1.46(0.96,2.23),2.51(1.71,3.69),and 4.45(3.10,6.39).The risk of metabolic syndrome and diabetes incidence risk increased with the increase of LAP levels,and the difference was statistically significant(P<0.001).The HR values of male cardiovascular and cerebrovascular diseases in the second,third and fourth quintile were 1.30(0.95,1.78),1.48(1.08,2.03)and 1.61(1.16,2.25),respectively.The females are 1.27(0.80,2.01),1.23(0.78,1.92),1.48(0.96,2.28),respectively.The incidence risk of cardiovascular and cerebrovascular diseases in males increased with the increase of LAP levels,and the difference was statistically significant(P<0.05).LAP,BMI and WC predict metabolic syndrome and the area under the ROC curve were BMI 0.775(0.759,0.790),LAP 0.753(0.737,0.749)and WC 0.684(0.666,0.701).The area under the ROC curve for predicting diabetes were LAP 0.680(0.625,0.637),BMI 0.652(0.645,0.659)and WC 0.651(0.644,0.658).The area under the ROC curve for predicting cardiovascular and cerebrovascular diseases were LAP 0.632(0.626,0.639),BMI 0.509(0.502,0.516)and WC 0.558(0.551,0.565).The area of LAP under the ROC curve for predicting diabetes and cardiovascular and cerebrovascular diseases was greater than that of BMI and WC,and the difference was statistically significant(P<0.05).Conclusion:1.The average level of LAP in female was higher than that in male.The level of LAP was positively correlated with age,waist circumference,body mass index,systolic blood pressure,diastolic blood pressure,fasting blood glucose,total cholesterol and triglycerides.2.The level of LAP was associated with the incidence of metabolic syndrome,diabetes and cardiovascular and cerebrovascular diseases in male.The risk of incidence increased with the increase of LAP level.The level of LAP was not associated with the incidence of cardiovascular and cerebrovascular diseases in female.3.LAP was superior to BMI and WC in predicting the risk of diabetes,cardiovascular and cerebrovascular diseases. |
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