Relationship Between Lipid Accumulation Index And Diabetes Mellitus In Different Sex Residents Of A Certain Area

Objective:To explore the relationship between LAP(lipid accumulation product)and the risk of diabetes in different sex residents,and to compare the predictive value of various obesity indicators and its combination to diabetes,so as to provide a basis for effective control of obesity and prevention of diabetes.Methods:A multi-stage cluster random sampling method was used to select 3115 permanent residents aged 18 or above in Longzihu District of Bengbu City,and questionnaire survey,physical examination and biochemical examination were conducted.Non-parametric test were used to compare the differences of basic characteristics ?various physical examination indices and biochemical indicators among different groups.Spearman correlation analysis was used to explore the correlation between various physical examination indices and biochemical indicators.Multivariate Logistic regression model was used to explore the relationship between LAP and the risk of diabetes.Area under curve(AUC)of receiver operating characteristics(ROC)curve was used to evaluate the predictive value of LAP(lipid accumulation product)?BMI(body mass index)?WC(waist circumference)?WHR(waist-to-hip ratio)?WHtR(waist-to-height ratio)and its combination to diabetes.LAP predicts the best cut-off point for the risk of developing diabetes using the maximum Youden index.Result:A total of 3115 people were investigated in this study,including 1307 males and1808 females.There were significant differences in age,alcohol consumption,physical activity and family history of diabetes between diabetic group and non-diabetic group in males(P < 0.05).The BMI,WC,WHtR,SBP,TG,FPG and LAP of male patients weresignificantly higher than those of non-diabetic patients(P < 0.05).There were significant differences in age,educational level,alcohol consumption and family history of diabetes between diabetic group and non-diabetic group in females(P < 0.05).The BMI,WC,WHR,WHtR,SBP,DBP,TG,TC,FPG and LAP of female patients were significantly higher than those of non-diabetic patients(P < 0.05).2.LAP was divided into 3 groups according to the tertile.It was found that there were significant differences in age and educational level among different LAP groups in males,and significant differences in age,educational level,physical activity and family history of diabetes among different LAP groups in females.3.There were significant differences in degree of obesity,blood pressure,fasting plasma glucose,and blood lipids among men and women in different LAP groups(all P<0.05).The BMI,WC,WHR,WHtR,TC and TG of the LAP second tertile were significantly higher than the first tertile,and the third tertile were significantly higher than the first and second tertiles.With the increase of LAP group,these indicators tended to increase in both males and females.In males,the fasting plasma glucose of the LAP third tertile was significantly higher than that in the first and second tertiles.Although the fasting plasma glucose of the LAP second tertile was higher than that in the first tertile,there was no significant difference(P=0.052)in males.While in females,with the increase of LAP group,the fasting plasma glucose is increasing.4.There was a positive correlation between the new obesity index LAP and the traditional obesity indices,fasting plasma glucose,blood pressure,total cholesterol and triglyceride(all P < 0.01).Compared with the traditional obesity indices,LAP is more correlated with fasting plasma glucose.5.With the increase of LAP,the prevalence of diabetes is increasing.After adjusting for related confounding factors,the OR(95%CI)for diabetes in the group with highest tertile LAP was 2.00(1.38-2.89)in men,and 3.82(2.46-5.93)in women,compared with the lowest tertile group,respectively.6.The ROC curve found that in men,the AUC of LAP in predicting the risk of diabetes was higher than BMI,WC,WHR,WHtR,but there was statistical significance only compared with WHR.In women,the AUC of LAP in predicting the risk of diabeteswas significantly higher than other obesity indicators(all P<0.05).The combination of different obesity indicators did not significantly improve the prediction of diabetes risk in both males and females.7.The best cut-off point for LAP in predicting the risk of diabetes was 51.63cm·mmol/L for males(sensitivity 0.37,specificity 0.76)and 37.24 cm·mmol/L for females(sensitivity 0.73,specificity 0.63).Conclusion:1.LAP is closely related to diabetes.The elevated level of LAP is associated with an increased risk of diabetes.2.LAP,prior to BMI,WC,WHR,WHtR,may be the best obesity-related index to predict adult diabetes,especially for women,LAP can better reflect the impact of obesity on diabetes.3.The combination of different obesity indicators did not significantly improve the predictive value of diabetes risk compared with the single obesity index LAP.