Lipid Accumulation Product and Cardiometabolic Index as Effective Tools for the Identification of Athletes at Risk for Metabolic Syndrome.

INTRODUCTION

Metabolic syndrome (MS) is a growing global public health concern that is associated with increased risk for cardiovascular events, even in athletes. The lipid accumulation product (LAP) index and cardiometabolic index (CMI) have been shown to be efficient markers of MS in the general population; its applicability in athletes has not been discussed yet. We aimed to assess the role of LAP and CMI in predicting MS in athletes.

METHODS

We retrospectively enrolled 793 Olympic athletes practicing different sporting disciplines (power, skill, endurance, and mixed), classified arbitrarily into no risk (NR), low risk (LR), high risk (HR), or MS if they had 0, 1, 2, or 3 criteria for MS, respectively. Evaluations included a calculation of the LAP index, CMI, anthropometric measurements, and clinical and laboratorial variables.

RESULTS

Among our population, only 0.8% reached the criteria for MS, 9.1% were at HR for MS, 37.8% were defined as LR, and 52.3% had NR. Significant differences in anthropometric parameters and the principal components of MS criteria (blood pressure, lipidic profile, glycemia) were reported predominantly in HR athletes and those with MS ( < 0.0001). LAP and CMI presented linearly increasing values from individuals with NR to those with MS ( < 0.0001). In addition, HR and MS athletes were classified as "likely MS" (9.8%) and LR and NR athletes as "unlikely MS" (90.2%). After adjusting for potential confounders, LAP ≥ 34.66 and CMI ≥ 0.776 emerged as independent predictors for MS in the overall cohort (Hazar Ratio (HR) 7.22 [3.75-13.89], < 0.0001, and HR 5.37 [2.96-9.73], < 0.0001, respectively). The ROC curve revealed that these cut-offs in the general population predict MS with an area under the curve (AUC) of 0.80 and 0.79, respectively, for LAP and CMI. However, gender-related cut-offs seem to be more precise in predicting MS (LAP ≥ 38.79 for male, LAP ≥ 14.16 for female, and CMI ≥ 0.881 for male and ≥0.965 for female).

CONCLUSION

The ROC curve analyses of LAP and CMI showed good diagnostic accuracy in predicting MS among athletes, despite the low prevalence of MS in our sample. Thus, these indexes may be used to promote screening for primary prevention and early detection of athletes at risk for MS to establish an early prevention strategy. Larger prospective studies are necessary to validate their benefit in the general population.