[A prospective study on the association between lipid accumulation product or body mass index and diabetes]

To measure the association between lipid accumulation product (LAP) or body mass index (BMI) and diabetes.

In this prospective study, subjects were recruited and followed up for more than five years from the program "Prevention of Multiple Metabolic Disorders and MS in Jiangsu Province" (PMMJS). A total number of 3598 people participating in the follow-up program, with complete information. Incidence rates of diabetes and relative risk in different levels of LAP and BMI were compared and analyzed. Areas under the receiver operation characteristic curve for obesity indicators such as LAP, BMI, waist circumference (WC), waist-to-hip ratio (WHR) in predicting diabetes of cohort population were calculated.

The number and the cumulative incidence of diabetes increased with the LAP levels in both men and women. After adjusting for age and other traditional risk factors on diabetes, the adjusted risk ratios (aRR) value of diabetes were 4.33 (1.34 - 14.01) for men and 5.04 (2.06 - 12.34) for women, between the highest and the lowest level of LAP groups. When further adjusted for BMI, the aRR value decreased to 3.15 (1.13 - 8.80) for men and 4.84 (2.16 - 10.84) for women. The number and the cumulative incidence of diabetes also increased with the BMI levels in both men and women but not significantly as the LAP showed, and the aRR values were 1.34 (0.61 - 2.93) for men and 1.69 (0.91 - 3.06) for women in the highest level of BMI group, when compared with the lowest level group. Again, when further adjusted for LAP, the aRR values decreased to 1.23 (0.59 - 2.69) for men and 1.39 (0.74 - 2.60) for women. The area under the ROC curve (AUC) for the four kinds of obesity indicators in predicting diabetes in the descending order were LAP, WHR, WC, BMI in both men and women.

LAP seemed more associated to diabetes than to BMI. When comparing with weight gain, diabetes might be more closely associated with the lipid accumulation product.