Lipid accumulation product (LAP): a key indicator for metabolic dysregulation and inflammatory status in obesity

The Lipid Accumulation Product (LAP) is recognized as an indicator of lipid-induced cellular stress. While its predictive value for conditions like diabetes, liver disease, and metabolic syndrome is established, its specific correlations with individual metabolic and hematological markers within the context of obesity remain less defined. This study sought to comprehensively investigate the links between LAP and a spectrum of metabolic and hematological biomarkers in individuals with obesity. This cross-sectional study involved 304 obese participants. Standard anthropometric measurements [weight, height, waist and hip circumference (WC, HC)] were taken, and dietary intake was assessed via a food frequency questionnaire. Blood samples were analyzed for glucose, insulin, hemoglobin A1C, serum lipids [total cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C)], and a complete blood cell count. LAP was calculated using WC and triglyceride levels. Participants were categorized into three tertiles based on their LAP values. Individuals in the highest LAP tertile had significantly higher body weight, body mass index, WC, and waist-to-hip ratio than those in the lowest tertile (all P < 0.05). Higher LAP tertiles were also associated with increased systolic and diastolic blood pressure, total cholesterol, triglycerides, and reduced HDL-C levels after adjustment for potential confounders. In addition, white blood cell count and mean corpuscular hemoglobin remained significantly higher across LAP tertiles in the fully adjusted models. Supplementary receiver operating characteristic (ROC) analysis demonstrated good discriminatory performance of LAP for identifying metabolic syndrome (AUC = 0.833; 95% CI: 0.779-0.887). Higher LAP was independently associated with an adverse cardiometabolic profile, characterized by greater adiposity, unfavorable lipid parameters, elevated blood pressure, and selected hematological alterations in adults with obesity. These findings support the potential utility of LAP as a simple and accessible marker for identifying individuals at increased cardiometabolic risk. However, prospective studies are needed to determine its predictive value and establish temporal relationships.