Lipid Accumulation Product as an Index for Visceral Obesity and Cardiovascular Risk among a Sample of Obese Egyptian Women


  • Nayera E. Hassan Department of Biological Anthropology, Medical Research Division, National Research Centre, Dokki, Giza, Egypt
  • Sahar A. El-Masry Department of Biological Anthropology, Medical Research Division, National Research Centre, Dokki, Giza, Egypt
  • Gamila S. M. El-Saeed Department of Medical Biochemistry, Medical Research Division, National Research Centre, Cairo, Egypt
  • Mohamed S. El Hussieny Department of Biological Anthropology, Medical Research Division, National Research Centre, Dokki, Giza, Egypt



Lipid accumulation product, Visceral fat, Cardiovascular risk factors, Egyptian women


Background:Lipid accumulation product (LAP) is one of the indices that can demonstrate cardiovascularrisk factors according to international studies. Aim: To evaluate relationship between LAP, visceral obesity and different cardio vascular risk factors among sample of obese Egyptian Women. Methods: A retrospective cross-sectional observational study included 350 obese Egyptian women; aged 25- 55 years. They were subjected to blood pressure and anthropometric assessment (weight, height and waist circumference), abdominal ultrasound (visceral fat) and laboratory tests (fasting blood sugar and lipid profile).Results: The majority of the participated women had wide WC (88.9%) and increased visceral fat (80.6%). Hyperglycemia was present among (47.4%), hypertension among 42.6%, high triglycerides among 26.6% and low HDL among 44.3%. The odds of obtaining LAP >80.74 cm.mmol/L (4th quartile) is 2.7 times higher in individuals with hypertension(BP > 130/85),and 6.79 times higher in individuals with visceral fat ≥ 5 cm. Depending on the visceral fat as a standard for classification of visceral obesity (>5 cm for women), revealed that the AUCs of LAP was 0.752 (95% CI 0.697–0.806) in women. The cutoff point of LAP;for prediction of visceral obesity among Egyptian women, was 61.69; using ROC analysis; with sensitivity 68% and specificity 75% and PPV/NPV 1.05 and accuracy 71.5% .Conclusion: LAP index had significant correlations with visceral obesity and hypertension. The cutoff point of LAP 61.69 can be used to predict visceral obesity among Egyptian women.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block


Vieira BA, Sauer P, Marcadenti A, Piovesan CH. Association between LAP index (lipid accumulation product) and metabolic profile in hospitalized patients. Nutr Hosp 2015;31(6):2771-4. PMid:26040394

Pinho CP, da Silva Diniz A, de Arruda IK, Leão AP, Rodrigues EC. Factors associated with the concentration of visceral and subcutaneous fat. Health Care Curr Rev 2017;5:4. DOI:

Jung CH, Rhee EJ, Kwon H, Chang Y, Ryu S, Lee WY. Visceral-to-subcutaneous abdominal fat ratio is associated with nonalcoholic fatty liver disease and liver fibrosis. Endocrinol Metab 2020;35(1):165-76. PMid:32207277 DOI:

Tehrani FR, Minooee S, Azizi F. Comparison of various adiposity indexes in women with polycystic ovary syndrome and normo-ovulatory non-hirsute women: A population based study. Eur J Endocrinol. 2014;171(2):199-207. PMid:24816947 DOI:

Ray L, Ravichandran K, Nanda SK. Comparison of lipid accumulation product index with body mass index and waist circumference as a predictor of metabolic syndrome in Indian population. Metab Syndr Relat Disord. 2018;16(5):240-5. PMid:29648916 DOI:

Mario FM, Graff SK, Spritzer PM. Adiposity indexes as phenotype-specific markers of preclinical metabolic alterations and cardiovascular risk in polycystic ovary syndrome: A cross-sectional study. Exp Clin Endocrinol Diabetes. 2017;125(5):307-15. PMid:28201826 DOI:

Kwon SH, Han AL. The correlation between the ratio of visceral fat area to subcutaneous fat area on computed tomography and lipid accumulation product as indexes of cardiovascular risk. J Obes Metab Syndr. 2019;28(3):186-93. PMid:31583383 DOI:

Song J, Zhao Y, Nie S, Chen X, Wu X, Mi J. The effect of lipid accumulation product and its interaction with other factors on hypertension risk in Chinese Han population: A cross-sectional study. PLoS One. 2018;13(6):e0198105. PMid:29874254 DOI:

Meuller W, Maughan RJ. The need for a novel approach to measure body composition: Is ultrasound an answer? Br J Sports Med. 2013;47(16):1001-2. PMid:23962880 DOI:

Sakuno T, Tomita LM, Tomita CM, de Carlos Back Giuliano I, Ibagy A, et al. Lisiane Schilling Poeta. Sonographic evaluation of visceral and subcutaneous fat in obese children. Radiol Bras. 2014;47(3):149-53. DOI:

Hiernaux J, Tanner JM. Growth and physical studies. In: Weiner JS, Lourie SA, editors. Human Biology: A Guide to Field Methods. London, Oxford, UK: IBP, Blackwell Scientific Publications; 1969.

Ribeiro-Filho FF, Faria AN, Azjen S, Zanella MT, Ferreira SR. Methods of estimation of visceral fat: advantages of ultrasonography. Obes Res. 2003;11(12):1488-94. PMid:14694213 DOI:

Allain CC, Poon LS, Chen CSG, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem. 1974;20(4):470-5. PMid:4818200 DOI:

Fossati P, Prencipe L. Serum triglycerides determination colorimetrically with an enzyme that produces hydrogen peroxide. Clin Chem. 1982;28:2077-88. PMid:6812986 DOI:

Burstein M, Scholnick HR, Morfin R. Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions. J Lipid Res. 1970;11(6):583-95. PMid:4100998 DOI:

Friedewald WI, Levy RI, Fredrickson DS. Estimation of the concentration of low density lipoprotein cholesterol in plasma without use of preparative ultracentrifuge. Clin Chem. 1972;18(6):499-502. PMid:4337382 DOI:

Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. 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. 2001;285(19):2486-97. PMid:11368702 DOI:

Amato MC, Giordano C, Galia M, Criscimanna A, Vitabile S, Midiri M, et al. Visceral adiposity index: A reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care. 2010;33(4):920-2. PMid:20067971 DOI:

Woldemariam MM, Evans KD, Butwin AN, Volz KR. Measuring abdominal visceral fat thickness with sonography: A methodologic approach. J Diagn Med Sonogr 2018;34(2):91-6. DOI:

Seravalle G, Grassi G. Obesity and hypertension. Pharmacol Res. 2017;122:1-7. PMid:28532816 DOI:

Oh YH, Moon JH, Kim HJ, Kong MH. Visceral-to-subcutaneous fat ratio as a predictor of the multiple metabolic risk factors for subjects with normal waist circumference in Korea. Diabetes Metab Syndr Obes. 2017;10:505-11. PMid:29270027 DOI:

HajianTilaki K, Heidari B. Is waist circumference a better predictor of diabetes than body mass index or waisttoheight ratio in Iranian adults? Int J Prev Med. 2015;6:5. PMid:25789140 DOI:

Kyrou I, Panagiotakos DB, Kouli GM, Georgousopoulou E, Chrysohoou C, Tsigos C, et al. Lipid accumulation product in relation to 10-year cardiovascular disease incidence in Caucasian adults: The ATTICA study. Atherosclerosis. 2018;279:10-6. PMid:30366186 DOI:

Adu EA, Obirikorang C, Acheampong E, Kwakye AS, Fokuoh F, Obirikorang Y, et al. Lipid accumulation product (LAP) index as a potential risk assessment for cardiovascular risk stratification among Type II diabetes mellitus in a Ghanaian population: A cross-sectional study. Cogent Med. 2019;6:1639880. DOI:

Gao X, Wang G, Wang A, Xu T, Tong W, Zhang Y. Comparison of lipid accumulation product with body mass index as an indicator of hypertension risk among Mongolians in China. Obes Res Clin Pract. 2013;7(4):e308-14. PMid:24306160 DOI:

Roriz C, Karla A, Passos S, Carlos L, de Oliveira C, Carolina, et al. Anthropometric clinical indicators in the assessment of visceral obesity: An update. Nutr Clín Diet Hosp. 2016;36(2):168-79.

Campbell NR, Lackland DT, Niebylski ML, World Hypertension League Committee, International Society of Hypertension Executive Committee. High blood pressure: Why prevention and control are urgent and important: A 2014 fact sheet from the world hypertension league and the international society of hypertension. J Clin Hypertens (Greenwich). 2014;16(8):551-3. PMid:25040331 DOI:

Bundy JD, He J. Hypertension and related cardiovascular disease burden in China. Ann Glob Health. 2016;82(2):227-33. PMid:27372527 DOI:

Wakabayashi I, Daimon T. A strong association between lipid accumulation product and diabetes mellitus in Japanese women and men. J Atheroscler Thromb. 2014;21(3):282-8. PMid:24304961 DOI:

Ioachimescu AG, Brennan DM, Hoar BM, Hoogwerf BJ. The lipid accumulation product and all-cause mortality in patients at high cardiovascular risk: A PreCIS database study. Obesity (Silver Spring). 2010;18(9):1836-44. PMid:20035284 DOI:

Tobias DK, Pan A, Jackson CL, O’Reilly EJ, Ding EL, Willett WC, et al. Body-mass index and mortality among adults with incident Type 2 diabetes. N Engl J Med. 2014;370(14):233-44. PMid:24693908 DOI:

Sun K, Lin D, Feng Q, Li F, Qi Y, Feng W, et al. Assessment of adiposity distribution and its association with diabetes and insulin resistance: A populationbased study. Diabetol Metab Syndr. 2019;11:51. Mid:31297161 DOI:

Klisic A, Kotur‐Stevuljevic J, Kavaric N, Matic M. Relationship between cystatin C, retinol‐binding protein 4 and Framingham risk score in healthy postmenopausal women. Arch Iran Med. 2016;19:845851. PMid:27998159

Pontes AG, Rehme MF, Martins AM, Micussi MT, Maranhão TM, Pimenta WP, et al. Insulin resistance in women with polycystic ovary syndrome: relationship with anthropometric and biochemical variables. Rev Bras Ginecol Obstet. 2012;34(2):74-9. PMid:22437766 DOI:

De Conti Cartolano F, Pappiani C, de Freitas MC, Neto AM, Carioca AA, et al. Is Lipid Accumulation Product Associated with an Atherogenic Lipoprotein Profile in Brazilian Subjects? Arq Bras Cardiol. 2018;110(4):339-47. PMid:29791572 DOI:

Freedman DS, Thornton JC, Pi-Sunyer FX, Heymsfield SB, Wang J, Pierson RN, et al. The body adiposity index (hip circumference ÷ height 1.5) is not a more accurate measure of adiposity than is BMI, waist circumference, or hip circumference. Obesity. 2012;20(12):2438-44. PMid:22484365 DOI:

Snijder MB, Nicolaou M, van Valkengoed IG, Brewster LM, Stronks K. Newly proposed body adiposity index (Bai) by Bergman et al. is not strongly related to cardiovascular health risk. Obesity. 2012;20(6):1138-9. PMid:22627979 DOI:

Porter SA, Massaro JM, Hoffmann U, Vasan RS, O’Donnel CJ, Fox CS. Abdominal subcutaneous adipose tissue: A protective fat depot? Diabetes Care. 2009;32(6):1068-75. PMid:19244087 DOI:

McLaughlin T, Lamendola C, Liu A, Abbasi F. Preferential fat deposition in subcutaneous versus visceral depots is associated with insulin sensitivity. J Clin Endocrinol Metab. 2011;96(11):E1756-60. PMid:21865361 DOI:

Nayera H, El-Masry S, El Hussieny M, El-Banna R, El Sherity S, Ebrahim E, et al. Visceral fat cut-off points for a sample of Egyptian adults. Maced J Med Sci. 2013;6(4):344-9. DOI:

Nascimento JX, Chein MB, de Sousa RM, dos Santos Ferreira A, Navarro PA, Brito LM. Importance of lipid accumulation product index as a marker of CVD risk in PCOS women. Lipids Health Dis. 2015;14:62. PMid:26104466 DOI:

Chiang JK, Koo M. Lipid accumulation product: A simple and accurate index for predicting metabolic syndrome in Taiwanese people aged 50 and over. BMC Cardiovasc Disord. 2012;12:78. PMid:23006530 DOI:




How to Cite

Hassan NE, El-Masry SA, El-Saeed GSM, El Hussieny MS. Lipid Accumulation Product as an Index for Visceral Obesity and Cardiovascular Risk among a Sample of Obese Egyptian Women. Open Access Maced J Med Sci [Internet]. 2021 Sep. 20 [cited 2024 Apr. 23];9(B):1229-36. Available from:

Most read articles by the same author(s)

1 2 > >>