Lipid Accumulation Product Index Predicts New-Onset Type 2 Diabetes Among Non-Obese Koreans: A 12-Year Longitudinal Study

Seung Ho Yang, Jihyun Yoon, Yong-Jae Lee, Byoungjin Park, Dong-Hyuk Jung Department of Family Medicine, Yonsei University College of Medicine, Seoul, Republic of KoreaCorrespondence: Dong-Hyuk Jung; Byoungjin Park, Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, 363 Dongbaekjukjeondae-ro, Giheung-gu, Yongin-si, Gyeonggi-do, 16995, Republic of Korea, Tel +82-31-5189-8762 ; +82 31 5189 8763, Fax +82-31-5189-8567, Email balsan2@yuhs.ac; bjpark96@yuhs.acPurpose: The lipid accumulation product (LAP) has been a potential indicator of central lipid accumulation status. This study aimed to assess the longitudinal association between LAP index and incident type 2 diabetes among non-obese Korean adults using a large, community-based Korean cohort observed over 12 years.Patients and Methods: This study included 4281 non-diabetic adults without generalized obesity and abdominal obesity and aged 40– 69 years from the Korean Genome and Epidemiology Study. The participants were divided into four groups according to LAP index quartiles, calculated as (waist circumference [cm] - 65) x (triglycerides [mmol/L]) in men and (waist circumference [cm] - 58) x (triglycerides [mmol/L]) in women. We prospectively assessed hazard ratios (HRs) with 95% confidential intervals (CIs) for incident type 2 diabetes using multivariate Cox proportional hazard regression models.Results: Overall, 608 (14.2%) participants developed type 2 diabetes during the follow-up period. HRs for incident type 2 diabetes in the second, third, and fourth LAP quartile were 1.32 (95% CI: 0.97– 1.79), 1.51 (95% CI: 1.11– 2.06), and 2.14 (95% CI: 1.56– 2.94), respectively, after adjusting for age, sex, body mass index, smoking status, alcohol intake, physical activity, mean arterial blood pressure, family history of diabetes, and impaired glucose tolerance.Conclusion: A high LAP index can be an additional indicator for new-onset T2DM among middle-aged and elderly non-obese Koreans.Keywords: lipid accumulation product index, prospective cohort study, incident type 2 diabetes, Koreans