Evaluation of Lipid Accumulation Product, Visceral Adiposity and Atherogenic Risk Indices in Type 2 Diabetics in Port Harcourt, Nigeria

Abstract

Background: This study evaluated lipid accumulation product index (LAPi), visceral adiposity index (VAI), and atherogenic risk indices in diabetics in Port Harcourt, Nigeria. Materials and Methods: A total of 300 subjects comprising 150 diabetic subjects (tests) and 150 non-diabetic subjects (controls) were recruited for the study. Subjects observed an overnight fast prior to sample collection. Fasting blood sugar (FBS) was determined using the glucose oxidase method. Fasting insulin was determined using the enzyme–linked immunosorbent assay (ELISA) method. Glycated haemoglobin (HbA1c) was determined using fluorescence immunoassay method. Insulin resistance was calculated using the homeostatic model assessment of insulin resistance (HOMA-IR). Triglyceride-glucose index (TyG) was calculated using standardized protocol. Total cholesterol (TCHOL), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) were determined using enzymatic methods. Low-density lipoprotein cholesterol (LDL-C) was calculated using Friedewald’s equation. Body mass index (BMI), waist to hip (WHR), lipid accumulation product index (LAPi) and visceral adiposity index (VAI) were calculated using their respective standardised protocols for calculation. The atherogenic risk indices; Castelli risk index I and II (CRI-I and CRI-II), atherogenic coefficient (AC), non-HDL cholesterol (non-HDL-C), triglyceride to HDL-C (TG/HDL-C) ratio, and the atherogenic index of plasma (AIP) were also calculated using their respective standardized protocols. Results: BMI, WHR, LAPi and VAI were significantly higher (P<0.05) in diabetic subjects compared to the non-diabetic controls. There were also significant differences (P<0.05) in HbA1c, HOMA-IR and TyG index as the diabetic subjects had higher values compared to the non-diabetic controls. TCHOL, TG and LDL-C were significantly higher (P<0.05), while HDL-C was significantly lower (P<0.05) in the diabetic group compared to the non-diabetic controls. The atherogenic indices (CRI-I, CRI-II, AC, non-HDL-C, TG/HDL, and AIP) were significantly higher (P<0.05) in the diabetic group compared to the non-diabetic controls. Correlation analyses indicated significant positive relationships between LAPi, VAI and HOMA-IR. LAPi and VAI were positively correlated with TyG, TG/HDL-C ratio, CRI-I, CRI-II, AC, non-HDL-C, and AIP. Conclusion: Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition characterised by insulin resistance, lipid accumulation, visceral/central adiposity and atherogenic dyslipidaemia. The vicious metabolic cycle in diabetes heightens the risk of cardiovascular complications. LAPi and VAI provide easy and sex-specific assessments of cardiometabolic risk, and should be incorporated in clinical settings in combination with the atherogenic indices, for early detection of cardiovascular risk and to improve patient outcomes.