Lipid accumulation product as a predictor of insulin resistance in Indian women with polycystic ovary syndrome-a cross sectional study
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20231223Keywords:
Insulin resistance, Lipid accumulation product, Polycystic ovary syndromeAbstract
Background: Polycystic ovary disease is the most common endocrine disorder among women of reproductive age group with a prevalence of around 6-18%. Asian population with PCOS are at a higher risk for insulin resistance and type-2 diabetes mellitus. Early screening and detection of insulin resistance can prevent future metabolic co-morbidities. Lipid accumulation product (LAP) is a new emerging index can identify insulin resistance and metabolic abnormalities among these women.
Methods: PCOS was diagnosed using Rotterdam criteria. Anthropometric measurements, biochemical parameters, insulin resistance (IR) and LAP were calculated. LAP was defined as [WC (cm) – 58] × TG (mmol/l). IR was defined using homeostatic model assessment-IR (HOMA-IR) and A cut off value >3.8 defined IR. LAP, BMI, waist circumference (WC) and waist-hip ratio (WHR) were compared using two-tailed spearman rank correlation test and analysing the receiver operator characteristic (ROC) curves.
Results: Among these women, the mean, IR and LAP were 3.56±2.17 and 39.58±24.82. 54% women had BMI>25 kg/m2. 43% PCOS women were insulin resistant (IR>3.8). Mean LAP values were significantly higher in cases than controls. 41% PCOS women had LAP value higher than cut off. (LAP>34.5). A strong positive and significant correlation was obtained between IR and LAP (rho=0.67, p<0.001) and was higher than the other parameters. Also, ROC curve analysis revealed, LAP had the maximum area under the curve (AUC).
Conclusions: LAP, an easily obtainable index, is an effective marker of insulin resistance and can be used to detect insulin resistance in PCOS as higher LAP values were observed in women with PCOS compared to controls.
References
Franks S. Polycystic ovary syndrome. Arch Dis Childhood. 1997;77(1):89-90
March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod. 2010;25(2):544-51.
Galluzzo A, Amato MC, Giordano C. Insulin resistance and polycystic ovary syndrome. Nutr Metab Cardiovasc Dis. 2008;18(7):511-8.
Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, et al. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2018;33(9):1602-18.
Martins WD, Soares GM, Vieira CS, Reis RM, Sá MF, Ferriani RA. Insulin resistance in women with polycystic ovary syndrome modifies cardiovascular risk factors. Braz J Gynecol Obstet. 2009;31:111-6.
Kaplan NM. The deadly quartet: upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med. 1989;149(7):1514-20.
Lee CM, Huxley RR, Wildman RP, Woodward M. Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol. 2008;61(7):646-53.
Kahn HS. The “lipid accumulation product” performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison. BMC Cardiovasc Disord. 2005;5(1):26
Rotterdam ESHRE/ASRM‐Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long‐term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41-7.
Consultation WH. Obesity: preventing and managing the global epidemic. World Health Organization technical report series. 2000;894:1-253.
Ganie MA, Marwaha RK, Dhingra A, Nisar S, Mani K, Masoodi S, et al. Observation of phenotypic variation among Indian women with polycystic ovary syndrome (PCOS) from Delhi and Srinagar. Gynecol Endocrinol. 2016;32(7):566-70.
Macut D, Božić Antić I, Bjekić-Macut J, Panidis D, Tziomalos K, Vojnović Milutinović D, et al. Lipid accumulation product is associated with metabolic syndrome in women with polycystic ovary syndrome. Hormones. 2016;15:35-44..
Wiltgen D, Benedetto IG, Mastella LS, Spritzer PM. Lipid accumulation product index: a reliable marker of cardiovascular risk in polycystic ovary syndrome. Hum Reprod. 2009;24(7):1726-31.
Wehr E, Gruber HJ, Giuliani A, Möller R, Pieber TR, Obermayer-Pietsch B. The lipid accumulation product is associated with impaired glucose tolerance in PCOS women. J Clin Endocrinol Metab. 2011 J;96(6):E986-90.
