Abstract 17680: Association of Lipid Accumulation Product with All-Cause, Cardiovascular or Ischemic Heart Disease Mortality: The National Health and Nutrition Examination Survey

Abstract

Introduction: The lipid accumulation product (LAP) has been proposed as an alternative continuous index of lipid accumulation, but the predictive role of LAP on mortality has not been adequately studied. LAP is based on a combination of waist circumference (WC) in cm and serum triglyceride (TG) in SI units: [LAP = (WC − 65) × TG for men and (WC − 58) × TG for women].

Objective: We examined association between LAP and risk of all-cause, cardiovascular (CVD) and ischemic heart disease (IHD) mortality in a nationally representative cohort.

Methods: Participants between ages 30 and 74 enrolled in the National Health and Nutrition Examination Survey (NHANES) III study from 1988 to 1994 had known CVD risk factors (age, sex, race, BMI, diabetes, hypertension, smoking history, triglycerides, history of CVD, family history of CVD and medication use) measured. All-cause, CVD and IHD mortality through 2006 were obtained via linkage with the National Death Index. Cox proportional hazards model was used to estimate hazards ratio (HR) and 95% confidence interval (CI) for mortality after adjusting for known CVD risk factors.

Results: 9864 participants (mean age 49.7 ± 13.4 years, 52.5 % females, and 31.8 % ethnic minorities) had complete data. Mean LAP was 63.7 ± 61.7. During 135, 746 person-years follow-up (median follow-up: 14.4 years), there were 2002 deaths including 603 CVD deaths and 452 IHD deaths. In multivariate analysis, comparing participants in LAP quartile 4 to quartile 1, the adjusted HR was 0.91 (95% CI, 0.79-1.05) for all-cause mortality, 0.98 (95% CI, 0.77-1.29) for CVD mortality, and 1.05 (95% CI, 0.78-1.42) for IHD mortality. Thus, increasing quartiles of LAP were not markers of risk for future all-cause, CVD or IHD mortality.

Conclusion: In a nationally representative sample of US adults, LAP did not predict all-cause, CVD or IHD mortality in entire cohort. Contrary to observations from earlier epidemiologic studies, LAP did not accurately reflect cardiovascular risk in our study.