Zooravar Diar, Shojaei Shayan, Mousavi Asma, Soltani Pedram, Amiri Bahareh Shateri, Radkhah Hanieh
School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Cardiac Primary Prevention Research Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Iran.
Clin Med Insights Endocrinol Diabetes. 2025 Aug 16;18:11795514251365301. doi: 10.1177/11795514251365301. eCollection 2025.
Emerging lipid-related biomarkers, including the Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Atherogenic Index of Plasma (AIP), have demonstrated potential in predicting metabolic disorders such as diabetes mellitus (DM) and associated microvascular complications, particularly diabetic kidney disease (DKD) and diabetic retinopathy (DR).
This systematic review and meta-analysis aims to evaluate the association between these biomarkers and microvascular complications in individuals with DM, as well as to assess their diagnostic performance.
A systematic literature search was performed in PubMed, Scopus, Embase, and Web of Science following PRISMA guidelines. Eligible studies examined the relationship between VAI, LAP, and AIP and microvascular complications in DM. The meta-analysis synthesized data using pooled weighted mean differences (WMDs) and area under the receiver operating characteristic curve (AUC) values to evaluate the predictive utility of these biomarkers for DKD and DR.
A total of 23 studies were included. Patients with DKD had significantly higher levels of LAP (WMD: 12.67; 95% CI: 7.83-17.51; < .01), AIP (WMD: 0.11; 95% CI: 0.03-0.19; < .01), and VAI (WMD: 0.63; 95% CI: 0.38-0.89; < .01) compared to those without DKD. Additionally, each 1-unit increase in LAP (OR: 1.005; 95% CI: 1.003-1.006; < .01), AIP (OR: 1.08; 95% CI: 1.04-1.12; < .01), and VAI (OR: 1.05; 95% CI: 1.03-1.07; < .01) was associated with an elevated risk of DKD. In contrast, no significant associations were identified between these biomarkers and DR. The diagnostic performance of VAI, LAP, and AIP was limited for both DR and DKD, with low discriminatory power.
VAI, LAP, and AIP are significant predictors of DKD in individuals with DM but exhibit limited relevance for the detection of DR. Although these biomarkers show potential in identifying DKD risk, their overall diagnostic accuracy for DKD and DR remains modest, underscoring the need for further studies to enhance their clinical applicability.
新兴的脂质相关生物标志物，包括内脏脂肪指数（VAI）、脂质蓄积产物（LAP）和血浆致动脉粥样硬化指数（AIP），已显示出在预测代谢紊乱（如糖尿病（DM））及其相关微血管并发症，特别是糖尿病肾病（DKD）和糖尿病视网膜病变（DR）方面的潜力。
本系统评价和荟萃分析旨在评估这些生物标志物与DM患者微血管并发症之间的关联，并评估它们的诊断性能。
按照PRISMA指南，在PubMed、Scopus、Embase和Web of Science中进行了系统的文献检索。符合条件的研究考察了VAI、LAP和AIP与DM微血管并发症之间的关系。荟萃分析使用合并加权平均差（WMD）和受试者工作特征曲线下面积（AUC）值来综合数据，以评估这些生物标志物对DKD和DR的预测效用。
共纳入23项研究。与无DKD的患者相比，DKD患者的LAP（WMD：12.67；95%CI：7.83 - 17.51；P <.01）、AIP（WMD：0.11；95%CI：0.03 - 0.19；P <.01）和VAI（WMD：0.63；95%CI：0.38 - 0.89；P <.01）水平显著更高。此外，LAP每增加1个单位（OR：1.005；95%CI：1.003 - 1.006；P <.01）、AIP（OR：1.08；95%CI：1.04 - 1.12；P <.01）和VAI（OR：1.05；95%CI：1.03 - 1.07；P <.01）与DKD风险升高相关。相比之下，未发现这些生物标志物与DR之间存在显著关联。VAI、LAP和AIP对DR和DKD的诊断性能有限，鉴别能力较低。
VAI、LAP和AIP是DM患者DKD的重要预测指标，但对DR的检测相关性有限。尽管这些生物标志物在识别DKD风险方面显示出潜力，但其对DKD和DR的总体诊断准确性仍然一般，这突出表明需要进一步研究以提高它们的临床适用性。
