Diabetes, Metabolic Syndrome and Obesity (May 2021)
Lipid Accumulation Product is Associated with Urinary Albumin-creatinine Ratio in Chinese Prediabitic Population: A Report from the REACTION Study
Abstract
Yang Liu,1,2,* Yun Wang,1,2,* Jie Wang,2 Kang Chen,2 Lingzi Jin,3 Weiqing Wang,4 Zhengnan Gao,5 Xulei Tang,6 Li Yan,7 Qin Wan,8 Zuojie Luo,9 Guijun Qin,10 Lulu Chen,11 Yiming Mu2 1Graduate School, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Department of Endocrinology, The First Medical Center of Chinese PLA General Hospital, Beijing, People’s Republic of China; 3Department of International Medical Services, Peking Union Medical College Hospital (Xidan Campus), Beijing, People’s Republic of China; 4Shanghai National Research Centre for Endocrine and Metabolic Diseases, State Key Laboratory of Medical Genomics, Shanghai Institute for Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 5Department of Endocrinology, Dalian Central Hospital, Dalian, Liaoning, People’s Republic of China; 6Department of Endocrinology, First Hospital of Lanzhou University, Lanzhou, Gansu, People’s Republic of China; 7Department of Endocrinology, Zhongshan University Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, People’s Republic of China; 8Department of Endocrinology, Southwest Medical University Affiliated Hospital, Luzhou, Sichuan, People’s Republic of China; 9Department of Endocrinology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China; 10Department of Endocrinology, First Affiliated Hospital of Zhengzhou University, Zhenzhou, Henan, People’s Republic of China; 11Department of Endocrinology, Wuhan Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yiming MuDepartment of Endocrinology, The First Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing, 100853, People’s Republic of ChinaTel +86-10-5549 9001Email [email protected]: Lipid accumulation product (LAP) as a powerful marker of visceral obesity is an independent risk factor of chronic kidney disease. The present study attempted to explore the association between LAP and albuminuria in prediabetic individuals.Methods: We conducted a cross-sectional study and enrolled 26,529 participants with prediabetes over 40 years old with prediabetes from seven provinces in China. LAP was calculated from waist circumference and fasting triglycerides. Elevated albuminuria was defined by urinary albumin-creatinine ratio (uACR) ≥ 30 mg/g. Propensity score matching was applied to reduce bias, comparison between LAP and other traditional visceral obesity indices was performed and multiple logistic regression models were conducted to assess the association between LAP and albuminuria in the prediabetic population.Results: Individuals with uACR ≥ 30 mg/g were older and had higher BP, BMI, WC, TG, fasting insulin, glycohemoglobin and LAP, as well as lower eGFR and HDL level. Multiple logistic regression analysis showed elevated LAP was associated with increased odds of albuminuria (OR [95%CI]Q2 vs Q1 1.09 [0.94, 1.27], OR [95%CI]Q3 vs Q1 1.13 [0.97, 1.31], OR [95%CI]Q4 vs Q1 1.42 [1.21, 1.67], P for trend=0.018), and superior over waist-to-hip ratio or waist-to-height ratio. Stratification indicated that the prediabetic population with higher LAP level and characterized by female gender, middle age, being overweight, and rise in blood pressure were more likely to have increased uACR.Conclusion: Elevated level of LAP was associated with increased albuminuria in the prediabetic population in China.Keywords: albuminuria, lipid accumulation product, prediabetes, visceral obesity
