Open Access Maced J Med Sci. 2021 Sep 20; 9(B):1229-1236. 1229
Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia
Open Access Macedonian Journal of Medical Sciences. 2021 Sep 20; 9(B):1229-1236.
https://doi.org/10.3889/oamjms.2021.7027
eISSN: 1857-9655
Category: B - Clinical Sciences
Section: Cardiology
Lipid Accumulation Product as an Index for Visceral Obesity and
Cardiovascular Risk among a Sample of Obese Egyptian Women
Nayera E. Hassan
1
, Sahar A. El-Masry
1
* , Gamila S. M. El-Saeed
2
, Mohamed S. El Hussieny
1
1
Department of Biological Anthropology, Medical Research Division, National Research Centre, Dokki, Giza, Egypt;
2
Department
of Medical Biochemistry, Medical Research Division, National Research Centre, Cairo, Egypt
Abstract
BACKGROUND: Lipid accumulation product (LAP) is one of the indices that can demonstrate cardiovascular risk
factors according to international studies.
AIM: The aim of the study was to evaluate relationship between LAP, visceral obesity, and diferent cardio vascular
risk factors among sample of obese Egyptian Women.
METHODS: A retrospective cross-sectional observational study included 350 obese Egyptian women; aged
25–55 years. They were subjected to blood pressure (BP) and anthropometric assessment (weight, height, and waist
circumference [WC]), abdominal ultrasound (visceral fat), and laboratory tests (fasting blood sugar and lipid profle).
RESULTS: The majority of the participated women had wide WC (88.9%) and increased visceral fat (80.6%).
Hyperglycemia was present among (47.4%), hypertension among 42.6%, high triglycerides among 26.6%, and low
high-density lipoprotein among 44.3%. The odds of obtaining LAP >80.74 cm.mmol/L (4
th
quartile) are 2.7 times
higher in individuals with hypertension (blood BP >130/85), and 6.79 times higher in individuals with visceral
fat ≥5 cm. Depending on the visceral fat as a standard for classifcation of visceral obesity (>5 cm for women),
revealed that the area under the curve of LAP was 0.752 (95% Confdence interval 0.697–0.806) in women. The
cutof point of LAP; for prediction of visceral obesity among Egyptian women, was 61.69; using receiver operating
characteristic analysis; with sensitivity 68% and specifcity 75% and positive predictive value/negative predictive
value 1.05 and accuracy 71.5%.
CONCLUSION: LAP index had signifcant correlations with visceral obesity and hypertension. The cutof point of
LAP 61.69 can be used to predict visceral obesity among Egyptian women.
Edited by: Mirko Spiroski
Citation: Hassan NE, El-Masry SA, El-Saeed GSM,
El Hussieny MS. Lipid Accumulation Product as an Index
forVisceral Obesity and Cardiovascular Risk among a
Sample of Obese Egyptian Women.
OpenAccess Maced J Med Sci. 2021 Sep 20; 9(B):1229-1236.
https://doi.org/10.3889/oamjms.2021.7027
Keywords: Lipid accumulation product; Visceral fat;
Cardiovascular risk factors; Egyptian women
*Correspondence: Sahar A. El-Masry, Department
of Biological Anthropology, National Research Centre,
33 El-Bohooth St., Dokki, Giza, Cairo 12622, Egypt.
E-mail: masrysa@yahoo.com
Received: 04-Aug-2021
Revised: 08-Sep-2021
Accepted: 10-Sep-2021
Copyright: © 2021 Nayera E. Hassan, Sahar A. El-Masry,
Gamila S. M. El-Saeed, Mohamed S. El Hussieny
Funding: This research did not receive any fnancial
support
Competing Interest: The authors have declared that no
competing interest exists
Open Access: This is an open-access article distributed
under the terms of the Creative Commons Attribution-
NonCommercial 4.0 International License (CC BY-NC 4.0)
Introduction
Obesity is the ffth leading cause of death
worldwide. It is a documented risk factor for large
number of metabolic abnormalities as insulin resistance,
dyslipidemia, higher levels of blood pressure (BP), and
cardiovascular diseases (CVD) [1].
Approximately 80% of all body fat is distributed
subcutaneously, accumulated largely at gluteo-femoral
regions, at the back and at anterior abdominal wall. The
visceral fat represents only 10–20% of the total amount
of fat in male and 5–8% in females [2]. Abdominal
obesity, in particularly high visceral fat, plays a crucial
role in the evolution of metabolic and CVD independent
of generalized obesity [3].
Multiple anthropometric measurements are
used regularly for assessment of obesity such as body
mass index (BMI), waist circumference (WC), and
waist-to-hip ratio, but most of them cannot distinguish
between visceral fat and subcutaneous fat [4].
Recently, mathematically calculated indices
have been considered reliable and efective [5]. These
methods are considered more applicable options, as
they include formulas and biochemical measures that
enable medical practice and research to enquire better
tracking and risk factors prevention [6].
Lipid accumulation product (LAP) is one
of these indices. It is described in the literature as
sensitive and specifc markers for assessment of
visceral fat compared to other traditional parameters
including WC and BMI. It is calculated as a combination
of WC and fasting triglyceride (TG). Its superiority
is the simultaneous refection of the anatomical and
physiological changes of fat over accumulation in adults.
According to international studies, LAP can demonstrate
risk factors associated with CVD fairly well [7].
In clinical practice, imaging modalities
including computed tomography (CT) and magnetic
resonance imaging are considered the gold standards
for assessment of visceral and subcutaneous fat.
Their high costs and radiation exposure in case of
CT enormously limit their widely use in medical feld.
Therefore, it is crucial to establish a simple and
efective method for the assessment of visceral obesity
in adults [8].