Accuracy of visceral adiposity indices and lipid accumulation products in the identification of adults at high cardiovascular risk

Ana Maria Gonçalvez Milla , Eduardo B.F. Chagas , Vitor Fernando Bordin Miola , Bárbara de Oliveira Zanuso , Elen Landgraf Guiguer , Adriano Cressoni Araújo , Ricardo José Tofano , Karina R. Quesada , Lucas F. Laurindo , Sandra M. Barbalho
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Abstract

Introduction

The lipid accumulation product (LAP) and visceral adipose index (VAI) are clinical markers of visceral obesity and were proposed as simple tools to estimate cardiovascular risk and mortality. The objective of this study was to analyze the accuracy of the VAI and LAP for high cardiovascular risk patients.

Methods

A cross-sectional observational study of accuracy was carried out in 193 patients of both sexes. In addition to the variables VAI and LAP, presence of comorbidities, education, level of physical activity and anthropometric data were obtained. Cardiovascular risk was determined by the Framingham score.

Results

No significant difference was observed in the sample in gender distribution (44.6% women; 55.4% men), 24.4% had low cardiovascular risk, 48.7% intermediate risk and 26.9% high cardiovascular risk. Linear regression analysis showed that VAI and LAP explain, respectively, only 2.4% and 5.2% of the variation in cardiovascular risk expressed by the Framingham score. The analysis of areas under the curve (AUC) for receiver operating characteristic (ROC) indicated a significant effect only of LAP to diagnose individuals with high cardiovascular risk, but with low sensitivity and specificity.

Conclusion

Our results indicate that VAI and LAP explain only a small percentage of the variation in the Framingham cardiovascular risk score. LAP index still deserves more attention in a cohort study, because, even with the limitations of a cross-sectional study, we observed an acceptable sensitivity for it so that the LAP can be used as a screening criterion for requesting more accurate tests.

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内脏脂肪指数和脂质积累产物在识别心血管高危成人中的准确性
脂质堆积产物(LAP)和内脏脂肪指数(VAI)是内脏肥胖的临床标志物,被认为是评估心血管风险和死亡率的简单工具。本研究的目的是分析VAI和LAP对心血管高危患者的准确性。方法对193名男女患者进行横断面观察研究。除了变量VAI和LAP外,还获得了合并症的存在、教育程度、体育活动水平和人体测量数据。心血管风险由Framingham评分决定。结果样本性别分布无显著差异(女性44.6%,男性55.4%),心血管低危人群24.4%,中危人群48.7%,心血管高危人群26.9%。线性回归分析表明,VAI和LAP分别只能解释Framingham评分所表达的心血管风险变化的2.4%和5.2%。受试者工作特征曲线下面积(AUC)的分析表明,LAP仅对诊断心血管高危个体有显著影响,但敏感性和特异性较低。结论VAI和LAP只能解释Framingham心血管风险评分变化的一小部分。在队列研究中,LAP指数仍然值得更多关注,因为即使有横断面研究的局限性,我们也观察到它的敏感性是可以接受的,因此LAP可以作为要求更准确测试的筛查标准。
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