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Archived Comments for: Erratum to: The "lipid accumulation product" performs better than the body mass index for recognizing cardiovascular risk: a population-based comparison

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  1. Is the “Lipid adipose product” (LAP) really an alternative index for the assessment of cardiovascular risk in obesity?

    Alexis Malavazos, 1School of Clinical Nutrition, 2Endocrinology Unit University of Milan, IRCCS Policlinico San Donato, Milan, Italy.

    12 June 2006

    Emanuele Cereda1, Federica Ermetici2, Lelio Morricone2, Bruno Ambrosi2 and Alexis Elias Malavazos1,2

    Recently, the “lipid accumulation product” (LAP), a new index describing central lipid overaccumulation, alternative to BMI (describing weight overaccumulation), has been proposed for recognizing cardiovascular risk by Kahn HS. (1). In further analysis, this continuous indicator of lipid accumulation has been demonstrated to perform better than BMI also for identifying adults with insulin resistance, elevated glucose, and diabetes (2). With interest in such matter and in agreement with this statement, we would ask to the author what is the real utility of LAP in recognising cardiovascular risk factors among obese patients (BMI ≥30 kg/m2).

    In fact, when estimating population quartile of BMI the upper cut points were set at 28.9 kg/m2 for men and 29.6 kg/m2 for women, but additional informations about the obese population are in lack. Obesity per-se has been fingered as an independent risk factor for cardiovascular disease (3). In particular, the visceral one may be implicated not only in metabolic abnormalities (4) but also in an increased predisposition to cardiac dysfunction also through its inflammatory background (5). It is well known that the higher is the BMI, the higher are the waist and triglycerides (4) and in obesity both parameters are impaired. Probably, LAP performs better than BMI in identifying cardiovascular risk also through its capacity in denoting insulin resistance (3). Therefore, obesity is a cause itself of some degree of insulin resistance.

    Thus, the analysis of Kahn is clearly an attempt of validating inexpensive research tools for identifying cardiovascular risk. The idea is really interesting but data on obese population should be collected and analysed accordingly, particularly when considering the routinary use of both these variables in evaluating the obese patient.

    References

    1. Kahn HS.: The "lipid accumulation product" performs better than the body mass index for

    recognizing cardiovascular risk: a population-based comparison. BMC Cardiovasc Disord.

    2005, 5: 26.

    2. Kahn HS.: The lipid accumulation product is better than BMI for identifying diabetes: a

    population-based comparison. Diabetes Care 2006, 29: 151-3

    3. Hubert HB, Feinleib M, McNamara PM, Castelli WP.: Obesity as an independent risk factor

    for cardiovascular disease: a 26-year follow-up of participants in the Framingham Study.

    Circulation. 1983, 67: 968–83.

    4. Wajchenberg BL.: Subcutaneous and visceral adipose tissue: their relation to the metabolic

    syndrome. Endocr Rev 2000, 21: 697-738

    5. Malavazos AE, Cereda E, Morricone L, Coman C, Corsi MM, Ambrosi B.: Monocyte

    chemoattractant protein 1: a possible link between visceral adipose tissue-associated

    inflammation and subclinical echocardiographic abnormalities in uncomplicated obesity.

    Eur J Endocrinol 2005, 153: 871-7

    Competing interests

    None

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