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Background and aimsSimple clinical algorithms including the fatty liver index (FLI) and lipid accumulation product (LAP) have been developed as surrogate markers for non-alcoholic fatty liver disease (NAFLD), constructed using (semi-quantitative) ultrasonography. This study aimed to validate FLI and LAP as measures of hepatic steatosis, as determined quantitatively by proton magnetic resonance spectroscopy (1H-MRS).MethodsData were collected from 168 patients with NAFLD and 168 controls who had undergone clinical, biochemical and anthropometric assessment. Values of FLI and LAP were determined and assessed both as predictors of the presence of hepatic steatosis (liver fat >5.5%) and of actual liver fat content, as measured by 1H-MRS. The discriminative ability of FLI and LAP was estimated using the area under the receiver operator characteristic curve (AUROC). As FLI can also be interpreted as a predictive probability of hepatic steatosis, we assessed how well calibrated it was in our cohort. Linear regression with prediction intervals was used to assess the ability of FLI and LAP to predict liver fat content. Further validation was provided in 54 patients with type 2 diabetes mellitus.ResultsFLI, LAP and alanine transferase discriminated between patients with and without steatosis with an AUROC of 0.79 (IQR=0.74, 0.84), 0.78 (IQR=0.72, 0.83) and 0.83 (IQR=0.79, 0.88) respectively although could not quantitatively predict liver fat. Additionally, the algorithms accurately matched the observed percentages of patients with hepatic steatosis in our cohort.ConclusionsFLI and LAP may be used to identify patients with hepatic steatosis clinically or for research purposes but could not predict liver fat content.

Lipid accumulation product (LAP) is an index used for evaluating lipid overaccumulation in adults. Our study aimed at assessing associations between LAP and metabolic syndrome (MetS) and its components, age-related testosterone deficiency syndrome (TDS), low-density cholesterol (LDL), as well as HOMA-IR (insulin resistance ratio), insulin level in non-diabetics and total testosterone (TT), estradiol E2, dehydroepiandrosterone sulphate (DHEAs) and sex hormone-binding globulin (SHBG) in aging men. 313 men aged 50–75 were surveyed with regard to the prevalence of diabetes (T2DM) and hypertension (HT). Anthropometric measurements, including waist circumference and arterial pressure, were performed. We also determined the levels of fasting plasma glucose (FPG), total cholesterol (TC), high-density cholesterol (HDL), low-density cholesterol (LDL), triglyceride (TG), insulin, TT, SHBG, DHEAs, and E2. Patients with diagnosed MetS, T2DM, HT, obesity, overweight and TDS had a significantly higher LAP compared to those without these conditions. LAP was significantly positively correlated with serum TC, FPG, insulin, DHEAs, as well as APB-systolic concentration, and negatively correlated with HDL, TT, and SHBG. LAP may then be used as a simple and inexpensive biomarker of metabolic disorders, and in risk assessment related to testosterone deficiency in aging men.

Background Dyslipidemia is a common complication in patients with diabetes and is involved in being prone to cardiovascular disease. The risk of coronary artery disease is known to be lower in light-to-moderate drinkers than in abstainers. The aim of this study was to clarify whether and how alcohol drinking influences the lipid-related indices, good predictors for cardiovascular disease, such as the ratio of LDL cholesterol to HDL cholesterol (LDL-C/HDL-C ratio), the ratio of triglycerides to HDL cholesterol (TG/HDL-C ratio), and the lipid accumulation product (LAP), in patients with diabetes. Methods The subjects were men with diabetes (n = 1477; mean age, 54.0 years) and they were divided into non-, light (< 22 g ethanol/day), moderate (≥ 22 and