We use cookies to improve your experience. By continuing to browse this site, you accept our cookie policy.×
Skip main navigation
Aging Health
Bioelectronics in Medicine
Biomarkers in Medicine
Breast Cancer Management
CNS Oncology
Colorectal Cancer
Concussion
Epigenomics
Future Cardiology
Future Medicine AI
Future Microbiology
Future Neurology
Future Oncology
Future Rare Diseases
Future Virology
Hepatic Oncology
HIV Therapy
Immunotherapy
International Journal of Endocrine Oncology
International Journal of Hematologic Oncology
Journal of 3D Printing in Medicine
Lung Cancer Management
Melanoma Management
Nanomedicine
Neurodegenerative Disease Management
Pain Management
Pediatric Health
Personalized Medicine
Pharmacogenomics
Regenerative Medicine

Lipid accumulation product is a valid predictor of hepatic steatosis and nonalcoholic fatty liver disease

    Qiaoli Huang‡

    Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, People's Republic of China

    ‡These authors contributed equally to this work

    Search for more papers by this author

    ,
    Xuying Tan‡

    Department of Children Healthcare, Guangzhou Women & Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, People's Republic of China

    ‡These authors contributed equally to this work

    Search for more papers by this author

    ,
    Qiongmei Wu

    Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, People's Republic of China

    ,
    Hanqing Zhao

    Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, People's Republic of China

    ,
    Hangjun Chen

    Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, People's Republic of China

    ,
    Xinxue Yu

    Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, People's Republic of China

    ,
    Jinting Wang

    Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, People's Republic of China

    ,
    Xueyi Huang

    Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, People's Republic of China

    ,
    Yurong Huang

    Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, People's Republic of China

    ,
    Jun Wei

    Department of Science & Technology, Guangzhou Customs, Guangzhou, 510623, People's Republic of China

    ,
    Feng Wu

    Department of Science & Technology, Guangzhou Customs, Guangzhou, 510623, People's Republic of China

    ,
    Huilian Zhu

    Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, People's Re-public of China

    &
    Lijun Wang

    *Author for correspondence: Tel.: +86 208 522 8059;

    E-mail Address: tswanglj5@jnu.edu.cn

    Department of Nutrition, School of Medicine, Jinan University, Guangzhou, 510632, People's Republic of China

    Published Online:https://doi.org/10.2217/bmm-2023-0725

    Aims: To evaluate and compare lipid accumulation product (LAP) with alanine aminotransferase (ALT), aspartate aminotransferase (AST), visceral adiposity index (VAI) and triglyceride-glucose index (TyG) as biomarkers for hepatic steatosis and nonalcoholic fatty liver disease (NAFLD). Methods: LAP, ALT, AST, VAI and TyG were measured in 52 biopsy-proven NAFLD patients and 21 control subjects. Additionally, LAP was also measured in 448 ultrasound-proven NAFLD patients and 1009 control subjects. Results: LAP was positively associated with hepatic steatosis and inflammation in biopsy-proven NAFLD. The risk of NAFLD was positively related to LAP and TyG, but LAP showed a better area under the receiver operating characteristic curve for hepatic steatosis and NAFLD. LAP also performed well in recognizing ultrasound-proven NAFLD. Conclusion: LAP is an ideal biomarker of hepatic steatosis and NAFLD.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1. Yi M, Peng W, Feng X et al. Extrahepatic morbidities and mortality of NAFLD: an umbrella review of meta-analyses. Aliment. Pharmacol. Ther. 56(7), 1119–1130 (2022).
    • 2. Younossi ZM, Golabi P, Paik JM, Henry A, Van Dongen C, Henry L. The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): a systematic review. Hepatology 77(4), 1335–1347 (2023).
    • 3. Loomba R, Friedman SL, Shulman GI. Mechanisms and disease consequences of nonalcoholic fatty liver disease. Cell 184(10), 2537–2564 (2021).
    • 4. Mcpherson S, Armstrong MJ, Cobbold JF et al. Quality standards for the management of non-alcoholic fatty liver disease (NAFLD): consensus recommendations from the British Association for the Study of the Liver and British Society of Gastroenterology NAFLD Special Interest Group. Lancet Gastroenterol. Hepatol. 7(8), 755–769 (2022).
    • 5. Powell EE, Wong VW, Rinella M. Non-alcoholic fatty liver disease. Lancet 397(10290), 2212–2224 (2021).
    • 6. Chalasani N, Younossi Z, Lavine JE et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology 67(1), 328–357 (2018).
    • 7. Kahn HS. The “lipid accumulation product” performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison. BMC Cardiovasc. Disord. 5(1), 1–10 (2005).
    • 8. Shu L, Zhao Y, Shen Y, Jia L, Zhang J. Interaction analysis of lipid accumulation product and family history of diabetes on impaired fasting glucose and diabetes risk in population with normotension in Eastern China: a community-based cross-sectional survey. Arch. Public Health 80(1), 217 (2022).
    • 9. Van Der Poorten D, Milner KL, Hui J et al. Visceral fat: a key mediator of steatohepatitis in metabolic liver disease. Hepatology 48(2), 449–457 (2008).
    • 10. Mato JM, Alonso C, Noureddin M, Lu SC. Biomarkers and subtypes of deranged lipid metabolism in non-alcoholic fatty liver disease. World J. Gastroenterol. 25(24), 3009–3020 (2019).
    • 11. Özcabı B, Demirhan S, Akyol M, Öztürkmen Akay H, Güven A. Lipid accumulation product is a predictor of nonalcoholic fatty liver disease in childhood obesity. Korean J. Pediatr. 62(12), 450–455 (2019).
    • 12. Ji BL, Li R, Zhang SH et al. The lipid accumulation product is highly related to serum alanine aminotransferase level in male adults. Nutr. Res. 32(8), 581–587 (2012).
    • 13. Zhang Y, Li B, Liu N, Wang P, He J. Evaluation of different anthropometric indicators for screening for nonalcoholic fatty liver disease in elderly individuals. Int. J. Endocrinol. 2021, 6678755 (2021).
    • 14. Liu Y, Wang W. Sex-specific contribution of lipid accumulation product and cardiometabolic index in the identification of nonalcoholic fatty liver disease among Chinese adults. Lipids Health Dis. 21(1), 8 (2022).
    • 15. Ebrahimi M, Seyedi SA, Nabipoorashrafi SA et al. Lipid accumulation product (LAP) index for the diagnosis of nonalcoholic fatty liver disease (NAFLD): a systematic review and meta-analysis. Lipids Health Dis. 22(1), 41 (2023).
    • 16. Preciado-Puga MC, Ruiz-Noa Y, Garcia-Ramirez JR et al. Non-invasive diagnosis of non-alcoholic fatty liver disease using an algorithm combining clinical indexes and ultrasonographic measures. Ann. Hepatol. 21, 100264 (2021). •• Explores the predictive ability of lipid accumulation product (LAP), FLI and right liver index diameter for nonalcoholic steatohepatitis (NASH; NAS ≥5) in a Mexican population.
    • 17. Li R, Liu J, Han P, Shi R, Zhao L, Li J. Associations between abdominal obesity indices and pathological features of non-alcoholic fatty liver disease: Chinese visceral adiposity index. J. Gastroenterol. Hepatol. 38(8), 1316–1324 (2023). •• This paper explores the predictive ability of LAP, Chinese visceral adiposity index and other noninvasive indicators for NASH in a Chinese population.
    • 18. Agganis B, Lee D, Sepe T. Liver enzymes: no trivial elevations, even if asymptomatic. Cleveland Clinic J. Med. 85(8), 612–617 (2018).
    • 19. Petta S, Amato M, Cabibi D et al. Visceral adiposity index is associated with histological findings and high viral load in patients with chronic hepatitis C due to genotype 1. Hepatology 52(5), 1543–1552 (2010).
    • 20. Simental-Mendía LE, Rodríguez-Morán M, Guerrero-Romero F. The product of fasting glucose and triglycerides as surrogate for identifying insulin resistance in apparently healthy subjects. Metab. Syndr. Relat. Disord. 6(4), 299–304 (2008).
    • 21. Xu C, Ma Z, Wang Y et al. Visceral adiposity index as a predictor of NAFLD: A prospective study with 4-year follow-up. Liver Int. 38(12), 2294–2300 (2018).
    • 22. Zhang S, Du T, Zhang J et al. The triglyceride and glucose index (TyG) is an effective biomarker to identify nonalcoholic fatty liver disease. Lipids Health Dis. 16(1), 15 (2017).
    • 23. Kleiner DE, Brunt EM, Van Natta M et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 41(6), 1313–1321 (2005).
    • 24. Amato MC, Giordano C, Galia M et al. Visceral Adiposity Index: A reliable indicator of visceral fat function associated with cardiometabolic risk. Diabetes Care 33(4), 920–922 (2010).
    • 25. Guerrero-Romero F, Simental-Mendía LE, GonzáLez-Ortiz M et al. The product of triglycerides and glucose, a simple measure of insulin sensitivity. Compar. Euglycemic-Hyperinsulinemic Clamp 95(7), 3347–3351 (2010).
    • 26. Fedchuk L, Nascimbeni F, Pais R, Charlotte F, Housset C, Ratziu V. Performance and limitations of steatosis biomarkers in patients with nonalcoholic fatty liver disease. Aliment. Pharmacol. Ther. 40(10), 1209–1222 (2014).
    • 27. Petta S, Amato MC, Di Marco V et al. Visceral adiposity index is associated with significant fibrosis in patients with non-alcoholic fatty liver disease. Aliment. Pharmacol. Ther. 35(2), 238–247 (2012).
    • 28. Vongsuvanh R, George J, Mcleod D, Van Der Poorten D. Visceral adiposity index is not a predictor of liver histology in patients with non-alcoholic fatty liver disease. J. Hepatol. 57(2), 392–398 (2012).
    • 29. Daniel S, Ben-Menachem T, Vasudevan G, Ma CK, Blumenkehl M. Prospective evaluation of unexplained chronic liver transaminase abnormalities in asymptomatic and symptomatic patients. Am. J. Gastroenterol. 94(10), 3010–3014 (1999).
    • 30. Pirimoğlu B, Sade R, Polat G, İşlek A, Kantarcı M. Analysis of correlation between liver fat fraction and AST and ALT levels in overweight and obese children by using new magnetic resonance imaging technique. Turkish J. Gastroenterol. 31(2), 156–162 (2020).
    • 31. Cuthbertson DJ, Weickert MO, Lythgoe D et al. External validation of the fatty liver index and lipid accumulation product indices, using 1H-magnetic resonance spectroscopy, to identify hepatic steatosis in healthy controls and obese, insulin-resistant individuals. Eur. J. Endocrinol. 171(5), 561–569 (2014).
    • 32. Weta IW, Mahadewa TGB, Sutirtayasa WP, Subawa A, Sitanggang FP, Widyadharma IPE. The comparison of simple anthropometric and biochemical parameters for predicting liver steatosis in obese Balinese Young women. Open Access Macedon. J. Med. Sci. 6(11), 2062–2066 (2018).
    • 33. Goessling W, Massaro JM, Vasan RS, D'agostino RB Sr, Ellison RC, Fox CS. Aminotransferase levels and 20-year risk of metabolic syndrome, diabetes, and cardiovascular disease. Gastroenterology 135(6), 1935–1944; e1931 (2008).
    • 34. Song K, Lee HW, Choi HS et al. Comparison of the modified TyG indices and other parameters to predict non-alcoholic fatty liver disease in youth. Biology 11(5), 685 (2022).
    • 35. Rivière B, Jaussent A, Macioce V et al. The triglycerides and glucose (TyG) index: A new marker associated with nonalcoholic steatohepatitis (NASH) in obese patients. Diabet. Metab. 48(4), 101345 (2022).
    • 36. Dai H, Wang W, Chen R, Chen Z, Lu Y, Yuan H. Lipid accumulation product is a powerful tool to predict non-alcoholic fatty liver disease in Chinese adults. Nutr. Metab. 14, 49 (2017).
    • 37. Tantanavipas S, Vallibhakara O, Sobhonslidsuk A et al. Abdominal obesity as a predictive factor of nonalcoholic fatty liver disease assessed by ultrasonography and transient elastography in polycystic ovary syndrome and healthy women. BioMed Res. Int. 2019, 9047324 (2019).
    • 38. Berk PD, Verna EC. Nonalcoholic fatty liver disease: lipids and insulin resistance. Clin. Liver Dis. 20(2), 245–262 (2016).
    • 39. Ulasoglu C, Enc FY, Kaya E, Yilmaz Y. Characterization of patients with biopsy-proven non-alcoholic fatty liver disease and normal aminotransferase levels. J. Gastrointest. Liver Dis. 28(4), 427–431 (2019).
    • 40. Uslusoy HS, Nak SG, Gülten M, Biyikli Z. Non-alcoholic steatohepatitis with normal aminotransferase values. World J. Gastroenterol. 15(15), 1863–1868 (2009).
    • 41. Oh RC, Hustead TR, Ali SM, Pantsari MW. Mildly Elevated Liver Transaminase Levels: Causes and Evaluation. Am. Family Phys. 96(11), 709–715 (2017).
    • 42. Sheng G, Lu S, Xie Q, Peng N, Kuang M, Zou Y. The usefulness of obesity and lipid-related indices to predict the presence of non-alcoholic fatty liver disease. Lipids Health Dis. 20(1), 134 (2021). • Suggests that triglyceride–glucose index-related parameters, LAP, HSI, body mass index and waist circumference appear to be good predictors of ultrasound-proven nonalcoholic fatty liver disease.
    • 43. Delong ER, Delong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics 44(3), 837–845 (1988).