Informative value of two obesity markers, body mass index (BMI) and lipid accumulation product (LAP), for assessing atherogenic risks in lipid profile: comparative analysis

View or download the full article: 
616-056.52; 612.123

A.M. Kaneva, E.R. Bojko


Institute of Physiology of Коmi Science Centre of the Ural Branch of the Russian Academy of Sciences, FRC Коmi SC UB RAS, 50 Pervomayskaya Str., Syktyvkar, Komi Republic, 167982, Russian Federation


The obesity epidemic is a global concern nowadays since obesity is a major risk factor that can cause many serious diseases. A high risk of developing diseases in an obese person primarily occurs due to metabolic disorders. As a rule, dyslipidemia acts as an early sign of metabolic disorders in case of obesity.

Our research goal was to compare informative value of body mass index (BMI) and lipid accumulation product (LAP) for assessing atherogenic risks in lipid profile.

Two thousand and four hundred people aged 20–60 years took part in our study. We determined participants’ anthropometric and clinical indicators and estimated lipid levels in blood serum.

As expected, LAP values had a strong correlation with BMI values. Spearman’s rank correlation coefficient for LAP and BMI values amounted to 0.73 (< 0.001) in men (n = 1168) and 0.77 (< 0.001) in women (n = 1232). However, when we estimated agreement between these two indicators using Cohen’s Kappa coefficient, we established that this agreement between LAP and BMI values was rather low (0.35 for men and 0.39 for women). Having compared samplings with quartiles that differed as per LAP and BMI values, we detected that lipid profiles tended to be more atherogenic in people with LAP values being higher than BMI values.

Given this established discordance in the quartiles, higher LAP values are associated with atherogenicity of lipid profile to a greater extent than values of BMI, the conventional obesity indicator. Using solely BMI to diagnose obesity may result in underestimating metabolic disorders in the body. To assess obesity and metabolic health correctly, it is advisable to determine LAP value together with traditional obesity indexes.

lipid accumulation product (LAP), body mass index (BMI), obesity, markers, waist circumference, triglycerides, atherogenicity, metabolism
Kaneva A.M., Bojko E.R. Informative value of two obesity markers, body mass index (BMI) and lipid accumulation product (LAP), for assessing atherogenic risks in lipid profile: comparative analysis. Health Risk Analysis, 2022, no. 3, pp. 160–167. DOI: 10.21668/health.risk/2022.3.15.eng
  1. Keys A., Fidanza F., Karvonen M.J., Kimura N., Taylor H.L. Indices of relative weight and obesity. J. Chronic. Dis., 1972, vol. 25, no. 6, pp. 329–343. DOI: 10.1016/0021-9681(72)90027-6
  2. Ashwell M. Obesity risk: importance of the waist-to-height ratio. Nurs. Stand., 2009, vol. 23, no. 41, pp. 49–54. DOI: 10.7748/ns2009.
  3. Valdez R., Seidell J.C., Ahn Y.I., Weiss K.M. A new index of abdominal adiposity as an indicator of risk for cardio-vascular disease. A cross-population study. Int. J. Obes. Relat. Metab. Disord., 1993, vol. 17, no. 2. pp. 77–82.
  4. Guerrero-Romero F., Rodríguez-Morán M. Abdominal volume index. An anthropometry-based index for estimation of obesity is strongly related to impaired glucose tolerance and type 2 diabetes mellitus. Arch. Med. Res., 2003, vol. 34, no. 5, pp. 428–432. DOI: 10.1016/S0188-4409(03)00073-0
  5. Bergman R.N., Stefanovski D., Buchanan T.A., Sumner A.E., Reynolds J.C., Sebring N.G., Xiang A.H., Watanabe R.M. A better index of body adiposity. Obesity (Silver Spring), 2011, vol. 19, no. 5, pp. 1083–1089. DOI: 10.1038/oby.2011.38
  6. Krakauer N.Y., Krakauer J.C. A new body shape index predicts mortality hazard independently of body mass index. PLoS One, 2012, vol. 7, no. 7, pp. e39504. DOI: 10.1371/journal.pone.0039504
  7. Amato M.C., Giordano C., Galia M., Criscimanna A., Vitabile S., Midiri M., Galluzzo A., AlkaMeSy Study Group. Visceral Adiposity Index: a reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care, 2010, vol. 33, no. 4, pp. 920–922. DOI: 10.2337/dc09-1825
  8. Wakabayashi I., Daimon T. The “cardiometabolic index” as a new marker determined by adiposity and blood lipids for discrimination of diabetes mellitus. Clin. Chim. Acta, 2015, vol. 438, pp. 274–278. DOI: 10.1016/j.cca.2014.08.042
  9. Kahn H.S. The lipid accumulation product is better than body mass index for identifying diabetes. Am. J. Epidemiol., 2005, vol. 161, no. 11, pp. S51.
  10. Obesity: preventing and managing the global epidemic: report of a WHO Consultation on Obesity. Geneva, WHO, 1998, 276 p.
  11. Kyrou I., Panagiotakos D.B., Kouli G.M., Georgousopoulou E., Chrysohoou C., Tsigos C., Tousoulis D., Pitsavos C. Lipid accumulation product in relation to 10-year cardiovascular disease incidence in Caucasian adults: The ATTICA study. Atherosclerosis, 2018, vol. 279, pp. 10–16. DOI: 10.1016/j.atherosclerosis.2018.10.015
  12. Zhong C., Xia W., Zhong X., Xu T., Li H., Zhang M., Wang A., Xu T. [et al.]. Lipid accumulation product and hyper-tension related to stroke: a 9.2-year prospective study among Mongolians in China. J. Atheroscler. Thromb., 2016, vol. 23, no. 7, pp. 830–838. DOI: 10.5551/jat.33514
  13. Wang H., Chen Y., Sun G., Jia P., Qian H., Sun Y. Validity of cardiometabolic index, lipid accumulation product, and body adiposity index in predicting the risk of hypertension in Chinese population. Postgrad. Med., 2018, vol. 130, no. 3, pp. 325–333. DOI: 10.1080/00325481.2018.1444901
  14. Ray L., Ravichandran K., Nanda S.K. Comparison of lipid accumulation product index with body mass index and waist circumference as a predictor of metabolic syndrome in Indian population. Metab. Syndr. Relat. Disord., 2018, vol. 16, no. 5, pp. 240–245. DOI: 10.1089/met.2017.0119
  15. Xia C., Li R., Zhang S., Gong L., Ren W., Wang Z., Li Q. Lipid accumulation product is a powerful index for recognizing insulin resistance in non-diabetic individuals. Eur. J. Clin. Nutr., 2012, vol. 66, no. 9, pp. 1035–1038. DOI: 10.1038/ejcn.2012.83
  16. Bozorgmanesh M., Hadaegh F., Azizi F. Diabetes prediction, lipid accumulation product, and adiposity measures;
    6-year follow-up: Tehran lipid and glucose study. Lipids Health Dis., 2010, vol. 9, pp. 45. DOI: 10.1186/1476-511X-9-45
  17. Drapkina O.M., Shepel R.N., Shalnova S.A., Deev A.D., Balanova Y.A., Evstifeeva S.E., Zhernakova Y.V., Imaeva A.E. [et al.]. Basic anthropometric indices and diabetes mellitus Type 2 in Russian population. Ratsional'naya farmakoterapiya v kardiologii, 2018, vol. 14, no. 5, pp. 725–732. DOI: 10.20996/1819-6446-2018-14-5-725-732 (in Russian).
  18. Kornoukhova L.A., Denisov N.L., Emanuel V.L. Laboratory predictors of the non-alcoholic fatty liver in the persons with abdominal obesity. Vestnik Sankt-Peterburgskogo universiteta. Meditsina, 2018, vol. 13, no. 4, pp. 376–388. DOI: 10.21638/11701/spbu11.2018.405 (in Russian).
  19. Svarovskaya A.V., Garganeeva A.A. Anthropometric indices obesity and cardiometabolic risk: is there a link? Kardio-vaskulyarnaya terapiya i profilaktika, 2021, vol. 20, no. 4, pp. 114–121. DOI: 10.15829/1728-8800-2021-2746 (in Russian).
  20. Dobiasova M., Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER (HDL)). Clin. Biochem., 2001, vol. 34, no. 7, pp. 583–588. DOI: 10.1016/s0009-9120(01)00263-6
  21. Omuse G., Maina D., Hoffman M., Mwangi J., Wambua C., Kagotho E., Amayo A., Ojwang P. [et al.]. Metabolic syn-drome and its predictors in an urban population in Kenya: A cross sectional study. BMC Endocr. Disord., 2017, vol. 17, no. 1, pp. 37. DOI: 10.1186/s12902-017-0188-0
  22. Rotter I., Rył A., Szylińska A., Pawlukowska W., Lubkowska A., Laszczyńska M. Lipid accumulation product (LAP) as an index of metabolic and hormonal disorders in aging men. Exp. Clin. Endocrinol. Diabetes, 2017, vol. 125, no. 3, pp. 176–182. DOI: 10.1055/s-0042-116071
  23. Oh J.-Y., Sung Y.-A., Lee H.J. The lipid accumulation product as a useful index for identifying abnormal glucose regulation in young Korean women. Diabet. Med., 2013, vol. 30, no. 4, pp. 436–442. DOI: 10.1111/dme.12052
  24. Kaneva A.M., Potolitsyna N.N., Bojko E.R. Range of values for lipid accumulation product (LAP) in healthy residents of the European North of Russia. Ozhirenie i metabolizm, 2020, vol. 17, no. 2, pp. 179–186. DOI: 10.14341/omet11278 (in Rus-sian).
  25. Farin H.M.F., Abbasi F., Reaven G.M. Body mass index and waist circumference correlate to the same degree with insulin-mediated glucose uptake. Metabolism, 2005, vol. 54, no. 10, pp. 1323–1328. DOI: 10.1016/j.metabol.2005.04.021
  26. Després J.P., Lemieux I., Bergeron J., Pibarot P., Mathieu P., Larose E., Rodés-Cabau J., Bertrand O.F., Poirier P. Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arterioscler. Thromb. Vasc. Biol., 2008, vol. 28, no. 6, pp. 1039–1049. DOI: 10.1161/ATVBAHA.107.159228
  27. Landis J.R., Koch G.G. The measurement of observer agreement for categorical data. Biometrics, 1977, vol. 33, pp. 159–174.
  28. De Conti Cartolano F., Pappiani C., de Freitas M.C.P., Figueiredo Neto A.M., Carioca A.A.F., Damasceno N.R.T. Is lipid accumulation product associated with an atherogenic lipoprotein profile in Brazilian subjects? Arq. Bras. Cardiol., 2018, vol. 110, no. 4, pp. 339–347. DOI: 10.5935/abc.20180054
  29. Motamed N., Razmjou S., Hemmasi G., Maadi M., Zamani F. Lipid accumulation product and metabolic syndrome: a population-based study in northern Iran, Amol. J. Endocrinol. Invest., 2016, vol. 39, no. 4, pp. 375–382. DOI: 10.1007/s40618-015-0369-5
  30. Hosseinpanah F., Barzin M., Erfani H., Serahati S., Ramezani Tehrani F., Azizi F. Lipid accumulation product and insu-lin resistance in Iranian PCOS prevalence study. Clin. Endocrinol. (Oxf.), 2014, vol. 81, no. 1, pp. 52–57. DOI: 10.1111/cen.12287
  31. Nascimento-Ferreira M.V., Rendo-Urteaga T., Vilanova-Campelo R.C., Carvalho H.B., da Paz Oliveira G., Paes Landim M.B., Torres-Leal F.L. The lipid accumulation product is a powerful tool to predict metabolic syndrome in undiagnosed Brazilian adults. Clin. Nutr., 2017, vol. 36, no. 6, pp. 1693–1700. DOI: 10.1016/j.clnu.2016.12.020
  32. Ibrahim M.M. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes. Rev., 2010, vol. 11, no. 1, pp. 11–18. DOI: 10.1111/j.1467-789X.2009.00623.x
  33. Romero-Corral A., Somers V.K., Sierra-Johnson J., Korenfeld Y., Boarin S., Korinek J., Jensen M.D., Parati G., Lo-pez-Jimenez F. Normal weight obesity: a risk factor for cardiometabolic dysregulation and cardiovascular mortality. Eur. Heart J., 2010, vol. 31, no. 6, pp. 737–746. DOI: 10.1093/eurheartj/ehp487
Accepted for publication: 

You are here