A statistically significant association between LAP and CAD was established through regression analysis (OR: 4.12, 95% CI: 2.06-6.23, P < .001), supporting its integration into clinical protocols as a gatekeeper screening mechanism for primary CAD prevention.
Key Findings
Results
LAP index was significantly associated with coronary artery disease risk in the NHANES 2017-2020 cohort.
Logistic regression analysis yielded an odds ratio of 4.12 (95% CI: 2.06-6.23, P < .001) for the association between LAP and CAD.
The study recruited 7860 participants, among whom 499 individuals were diagnosed with CAD.
LAP combines waist circumference and triglyceride measurements to evaluate adipose tissue deposition.
A statistically significant elevation in LAP levels was observed among CAD patients compared to those without CAD.
Results
LAP demonstrated moderate-to-good discriminatory power for CAD as assessed by ROC curve analysis.
The area under the ROC curve (AUC) for LAP was 0.789 (95% CI: 0.773-0.805, P < .001).
LAP's predictive performance was compared to other metabolic markers using ROC analysis.
The AUC value of 0.789 was characterized as reflecting 'moderate-to-good discriminatory power' for CAD.
Methods
The study population included 7860 participants drawn from the NHANES 2017-2020 database, with a CAD prevalence of approximately 6.3%.
499 of 7860 total participants were diagnosed with CAD, yielding a prevalence of approximately 6.35%.
Data were sourced from the National Health and Nutrition Examination Survey 2017-2020 database.
The study design was observational in nature.
Methods
Subgroup analyses and interaction tests were performed to assess the robustness of the LAP-CAD association across different population strata.
Subgroup analyses were conducted to detect possible effect modifiers.
Interaction tests were used to verify the robustness of findings across different population subgroups.
The paper notes that existing research findings regarding LAP's association with CAD 'remain inconsistent,' motivating the subgroup approach.
Background
CAD predominantly affects obese individuals and those with metabolic abnormalities, providing the clinical rationale for evaluating LAP as a screening metric.
LAP combines waist circumference (WC) and triglyceride (TG) measurements as a 'clinically relevant metric for evaluating adipose tissue deposition.'
The authors position LAP as a potential 'gatekeeper screening mechanism for primary CAD prevention.'
The study situates itself within existing inconsistency in the literature regarding LAP and CAD associations.
What This Means
This research used data from nearly 8,000 Americans collected between 2017 and 2020 to examine whether a simple measurement called the Lipid Accumulation Product (LAP) index could help identify people at risk for coronary artery disease (CAD), a condition where the arteries supplying the heart become narrowed or blocked. LAP is calculated by combining two readily available measurements — waist circumference and blood triglyceride (fat) levels — making it inexpensive and easy to obtain in a clinical setting. Among the nearly 500 participants diagnosed with CAD in this study, LAP levels were significantly higher than in those without the disease.
The statistical analysis showed that higher LAP scores were associated with roughly four times greater odds of having CAD, and the index performed moderately well at distinguishing people with CAD from those without it, achieving an accuracy score (AUC) of about 0.79 out of a maximum of 1.0. This performance was compared favorably to other metabolic markers. The researchers also tested whether the relationship held up across different groups of people (such as by age, sex, or other health conditions) and found that the findings were generally consistent.
This research suggests that the LAP index, because it is simple to calculate and shows a meaningful link to coronary artery disease risk, could potentially be used as an early screening tool to flag individuals who may need further cardiovascular evaluation. However, since this was an observational study, it cannot prove that high LAP directly causes CAD, and further research would be needed before such a tool could be formally recommended in clinical practice.
Liu K, Zhong Y, Zhang H, Qin S, Liu L, Li Q, et al.. (2026). Association between lipid accumulation product index (LAP index) and coronary artery disease risk: An observational study based on NHANES 2017-2020.. Medicine. https://doi.org/10.1097/MD.0000000000050642