Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran.
Clin Endocrinol (Oxf). 2014 Jul;81(1):52-7. doi: 10.1111/cen.12287. Epub 2013 Aug 9.
To evaluate diagnostic accuracy of lipid accumulation product (LAP) index as a marker of insulin resistance in a community-based population with polycystic ovary syndrome (PCOS), compared with healthy women.
Anthropometric measurements, biochemical parameters, LAP index and insulin resistance (IR) were compared in 134 PCOS subjects and 414 healthy women recruited from 1126 reproductive aged women (18-45 years), participants of the Iranian PCOS Prevalence Study. LAP was defined as [WC (cm)-58] ×TG (mmol/l)]. PCOS was diagnosed using the Rotterdam criteria, and IR was defined using the homeostatic model assessment IR. LAP, body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) were compared using the two-tailed Spearman rank correlation test and analysing the receiver operating characteristic (ROC) curves for IR.
Among the PCOS subjects, the mean ± SD age, BMI, WC and WHR were 32·2 ± 7·7 years, 26·8 ± 5·8 kg/m(2) , 85·2 ± 13·2 cm and 0·80 ± 0·06, respectively, and the median (IQ25-75) of LAP index was 34·03 (17·8-66·3). There was significant correlation between HOMA-IR index and LAP in patients with PCOS (r = 0·41; P < 0·001). Also, ROC curves analysis revealed that the optimal cut-off value for LAP to define the presence of IR was 34·1 (sensitivity: 75%; specificity: 58%). LAP showed the highest area under curve (AUC) (P < 0·001).
Among PCOS subjects, LAP index has the strongest diagnostic accuracy for detection of IR in comparison with BMI, WC and WHR.
评估脂联素聚集产物（LAP）指数作为多囊卵巢综合征（PCOS）患者胰岛素抵抗标志物的诊断准确性，与健康女性进行比较。
在伊朗 PCOS 患病率研究的 1126 名育龄女性（18-45 岁）参与者中，招募了 134 名 PCOS 患者和 414 名健康女性，比较了这些女性的人体测量学指标、生化参数、LAP 指数和胰岛素抵抗（IR）。LAP 定义为[WC（cm）-58]×TG（mmol/l)]。采用 Rotterdam 标准诊断 PCOS，采用稳态模型评估 IR 定义 IR。使用双尾 Spearman 秩相关检验比较 LAP、体重指数（BMI）、腰围（WC）和腰臀比（WHR），并分析用于 IR 的受试者工作特征（ROC）曲线。
在 PCOS 患者中，平均±标准差年龄、BMI、WC 和 WHR 分别为 32.2±7.7 岁、26.8±5.8kg/m²、85.2±13.2cm 和 0.80±0.06，LAP 指数的中位数（25-75%分位数）为 34.03（17.8-66.3）。在 PCOS 患者中，HOMA-IR 指数与 LAP 呈显著相关性（r=0.41；P<0.001）。此外，ROC 曲线分析显示，LAP 定义 IR 存在的最佳截断值为 34.1（敏感性：75%；特异性：58%）。LAP 具有最高的曲线下面积（AUC）（P<0.001）。
在 PCOS 患者中，与 BMI、WC 和 WHR 相比，LAP 指数对 IR 的诊断准确性最高。
