Li Xiaocheng, Wang Jun, Leng Kai
Department of Hepatopancreatobiliary Surgery, Third Affiliated Hospital of Zunyi Medical University (The First People's Hospital of Zunyi), Zunyi, Guizhou, China.
PLoS One. 2024 Dec 5;19(12):e0315235. doi: 10.1371/journal.pone.0315235. eCollection 2024.
Abdominal obesity and insulin resistance are key risk factors for gallstones. The Lipid Accumulation Product (LAP), which combines waist circumference and triglyceride levels, may be a superior marker for visceral fat accumulation. However, its association with gallstone risk is unclear.
Data from 3294 participants in the National Health and Nutrition Examination Survey (NHANES) 2017-2020 cycle were analyzed. Weighted logistic regression, subgroup analyses, and restricted cubic spline (RCS) analysis explored the relationship between LAP and gallstone risk. ROC analysis, along with Random Forest and CatBoost models, compared the predictive abilities of LAP with BMI.
Weighted logistic regression analysis showed that each unit increase in Ln-LAP was associated with a 52% higher risk of gallstones (OR: 1.52; 95% CI: 1.24-1.86; P = 0.009). Compared to the lowest tertile (T1), the second tertile (T2) had a higher risk of gallstones (OR: 1.76; 95% CI: 1.09-2.84; P = 0.082), and the third tertile (T3) had an even higher risk (OR: 2.27; 95% CI: 1.47-3.49; P = 0.021). RCS analysis showed a nonlinear positive relationship between Ln-LAP and gallstone risk (non-linear P < 0.001). Subgroup analyses indicated that Ln-LAP was significantly positively associated with the risk of gallstones in most subgroups, with no significant interactions observed among the subgroups. Weighted logistic regression analysis revealed a significant positive association between BMI ≥ 30 kg/m2 (obesity) and the risk of gallstones. ROC analysis indicated that Ln-BMI is a better predictor of gallstone risk than Ln-LAP. However, in Random Forest and CatBoost models, LAP exhibited predictive value similar to BMI for gallstone risk.
While LAP is significantly and positively associated with an increased risk of gallstones, BMI generally appears to be a stronger predictor. However, LAP may still serve as a comparable marker under specific modeling conditions. Further research is needed to explore the relationship between LAP and gallstone risk.
腹部肥胖和胰岛素抵抗是胆结石的关键危险因素。脂质蓄积产物（LAP）结合了腰围和甘油三酯水平，可能是内脏脂肪蓄积的一个更好指标。然而，其与胆结石风险的关联尚不清楚。
分析了2017 - 2020年国家健康与营养检查调查（NHANES）中3294名参与者的数据。采用加权逻辑回归、亚组分析和受限立方样条（RCS）分析来探究LAP与胆结石风险之间的关系。通过ROC分析以及随机森林和CatBoost模型，比较了LAP与BMI的预测能力。
加权逻辑回归分析显示，Ln - LAP每增加一个单位，胆结石风险就会增加52%（OR：1.52；95%CI：1.24 - 1.86；P = 0.009）。与最低三分位数（T1）相比，第二三分位数（T2）患胆结石的风险更高（OR：1.76；95%CI：1.09 - 2.84；P = 0.082），第三三分位数（T3）的风险更高（OR：2.27；95%CI：1.47 - 3.49；P = 0.021）。RCS分析显示Ln - LAP与胆结石风险之间存在非线性正相关（非线性P < 0.001）。亚组分析表明，在大多数亚组中Ln - LAP与胆结石风险显著正相关，各亚组之间未观察到显著的相互作用。加权逻辑回归分析显示BMI≥30 kg/m²（肥胖）与胆结石风险之间存在显著正相关。ROC分析表明，Ln - BMI比Ln - LAP更能预测胆结石风险。然而，在随机森林和CatBoost模型中，LAP对胆结石风险表现出与BMI相似的预测价值。
虽然LAP与胆结石风险增加显著正相关，但BMI总体上似乎是一个更强的预测指标。然而，在特定建模条件下，LAP仍可作为一个可比指标。需要进一步研究来探索LAP与胆结石风险之间的关系。
