The Relationship between Lipid Accumulation Product, Insulin Resistance, and Obesity in Korean Adults
DOI:
https://doi.org/10.18063/ghl.v5i1.300Keywords:
Insulin resistance, Lipid accumulation product, Metabolic syndrome, ObeseAbstract
Lipid accumulation product (LAP) is a new index reflecting central lipid accumulation and is known to be a strong independent indicator for identifying the risk of cardiovascular disease (CVD) or diabetes mellitus (DM). This study was conducted to assess the relationship between the homeostasis model assessment of insulin resistance (HOMA-IR) and LAP according to the presence or absence of obesity in Korean adults. The study was carried out using data from the 2019 Korean National Health and Nutrition Examination Survey (KNHANES) and included 6,090 adults aged 20 years or older. There were several key findings. First, after adjusting for related variables, the mean of the HOMA-IR levels (M ± SE, 95% confidence interval) was positively associated with the quartiles of LAP in the overall population (P < 0.001), non-obese (P < 0.001), or obese groups (P < 0.001). Second, in all the groups (overall population, non-obese, and obese groups), the mean value of the fasting blood glucose (P < 0.001), insulin (P < 0.001), and the metabolic syndrome score (P < 0.001) increased with the increasing quartiles of LAP. Insulin resistance was thus positively associated with an increase in the LAP in Korean adults with or without obesity.
References
World Health Organization (WHO), Obesity and Overweight, 2021, https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Oh K, Kim Y, Kweon S, et al., 2021, Korea National Health and Nutrition Examination Survey, 20th Anniversary: Accomplishments and Future Directions. Epidemiol Health, 43: e2021025. https://doi.org/10.4178/epih.e2021025
Allott EH, Hursting SD, 2015, Obesity and Cancer: Mechanistic Insights from Transdisciplinary Studies. Endocr Relat Cancer, 22(6): R365–R386. https://doi.org/10.1530/ERC-15-0400
Luo L, Liu M, 2016, Adipose Tissue in Control of Metabolism. J Endocrinol, 231(3): R77–R99. https://doi.org/10.1530/JOE-16-0211
Kahn HS, 2005, The “Lipid Accumulation Product” Performs Better than the Body Mass Index for Recognizing Cardiovascular Risk: A Population-Based Comparison. BMC Cardiovasc Disord, 5: 26. https://doi.org/10.1186/1471-2261-5-26
Schaffer JE, 2003, Lipotoxicity: When Tissues Overeat. Curr Opin Lipidol, 14(3): 281–287. https://doi.org/10.1097/00041433-200306000-00008
Martin BC, Warram JH, Krolewski A, et al., 1992, Role of Glucose and Insulin Resistance in Development of Type 2 Diabetes Mellitus: Results of a 25-Year Follow-Up Study. The Lancet, 340(8825): 925–929. https://doi.org/10.1016/0140-6736(92)92814-v
DeFronzo RA, Ferrannini E, 1991, Insulin Resistance: A Multifaceted Syndrome Responsible for NIDDM, Obesity, Hypertension, Dyslipidemia, and Atherosclerotic Cardiovascular Disease. Diabetes Care, 14(3): 173–194. https://doi.org/10.2337/diacare.14.3.173
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, 2001, Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA, 285(19): 2486–2497. https://doi.org/10.1001/jama.285.19.2486
Yoon H, 2020, Relationship between Metabolic Syndrome, Metabolic Syndrome Score, Insulin Resistance and Beta Cell Function in Korean Adults with Obesity. Korean J Clin Lab Sci, 52: 327–334. https://doi.org/10.15324/kjcls.2020.52.4.327
Matthews DR, Hosker JP, Rudenski AS, et al., 1985, Homeostasis Model Assessment: Insulin Resistance and Beta Cell Function from Fasting Plasma Glucose and Insulin Concentrations in Man. Diabetologia, 28: 412–419. https://doi.org/10.1007/BF00280883
Nam GE, Kim YH, Han K, et al., 2020, Obesity Fact Sheet in Korea, 2019: Prevalence of Obesity and Abdominal Obesity from 2009 to 2018 and Social Factors. J Obes Metab Syndr, 29(2): 124–132. https://doi.org/10.7570/jomes20058
Sung HH, Gi MY, Cha JA, et al., 2022, Gender Difference in the Relationship between Lipid Accumulation Product Index and Pulse Pressure in Nondiabetic Korean Adults: The Korean National Health and Nutrition Examination Survey 2013–2014. Clin Exp Hypertens, 44(2): 146–153. https://doi.org/10.1080/10641963.2021.2007943
Lim S, 2018, Eating a Balanced Diet: A Healthy Life Through a Balanced Diet in the Age of Longevity. J Obes Metab Syndr, 27(1): 39–45. https://doi.org/10.7570/jomes.2018.27.1.39
Zheng D, Dou J, Liu G, et al., 2019, Association Between Triglyceride Level and Glycemic Control Among Insulin-Treated Patients with Type 2 Diabetes. J Clin Endocrinol Metab, 104(4): 1211–1220. https://doi.org/10.1210/jc.2018-01656
Longo M, Zatterale F, Naderi J, et al., 2019, Adipose Tissue Dysfunction as Determinant of Obesity-Associated Metabolic Complications. Int J Mol Sci, 20(9): 2358. https://doi.org//10.3390/ijms20092358
Shin KA, 2019, Comparison of Predictive Value of Obesity and Lipid Related Variables for Metabolic Syndrome and Insulin Resistance in Obese Adults. Biomed Sci Letters, 25: 256–266. https://doi.org/10.15616/BSL.2019.25.3.256
Sun K, Lin D, Feng Q, et al., 2019, Assessment of Adiposity Distribution and Its Association with Diabetes and Insulin Resistance: A Population-Based Study. Diabetol Metab Syndr, 11: 51. https://doi.org//10.1186/s13098-019-0450-x
Mirmiran P, Bahadoran Z, Azizi F, 2014, Lipid Accumulation Product is Associated with Insulin Resistance, Lipid Peroxidation, and Systemic Inflammation in Type 2 Diabetic Patients. Endocrinol Metab, 29(4): 443–449. https://doi.org/10.3803/EnM.2014.29.4.443
Borén J, Taskinen MR, Olofsson SO, et al., 2013, Ectopic Lipid Storage and Insulin Resistance: A Harmful Relationship. J Intern Med, 274(1): 25–40. https://doi.org/10.1111/joim.12071
Chiang JK, Koo M, 2012, Lipid Accumulation Product: A Simple and Accurate Index for Predicting Metabolic Syndrome in Taiwanese People Aged 50 and Over. BMC Cardiovasc Disord, 12: 78. https://doi.org/10.1186/1471-2261-12-78
Ye J, 2013, Mechanisms of Insulin Resistance in Obesity. Front Med, 7: 14–24. https://doi.org/10.1007/s11684-013-0262-6
Xia C, Li R, Zhang S, et al., 2012, Lipid Accumulation Product is a Powerful Index for Recognizing Insulin Resistance in Non-Diabetic Individuals. Eur J Clin Nutr, 66: 1035–1038. https://doi.org/10.1038/ejcn.2012.83
Taverna MJ, Martínez-Larrad MT, Frechtel GD, et al., 2011, Lipid Accumulation Product: A Powerful Marker of Metabolic Syndrome in Healthy Population. Eur J Endocrinol, 164(4): 559–567. https://doi.org/10.1530/EJE-10-1039
Pineda H, Castro J, Lares M, et al., 2017, Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI) a Simple and Clinically Useful Surrogate Marker for Metabolic Syndrome and Cardiovascular Disease Predictor in Non-Diabetic Venezuelan Adult. J Pharm Pharm Scien, 2(1): 1–8. https://doi.org/10.24218/vjpps.2017.20
Wallace TM, Levy JC, Matthews DR, 2004, Use and Abuse of HOMA Modeling. Diabetes Care, 27(6): 1487–1495. https://doi.org/10.2337/diacare.27.6.1487
Pham H, Utzschneider KM, de Boer IH, 2011, Measurement of Insulin Resistance in Chronic Kidney Disease. Curr Opin Nephrol Hypertens, 20(6): 640–646. https://doi.org/10.1097/MNH.0b013e32834b23c1
