Objective ·To explore the correlation between lipid accumulation product (LAP) and hypertension in Chinese adults. Methods ·By searching the English literature databases including PubMed and Web of Science, and the Chinese literature databases including CNKI and WanFang Data Knowledge Service Platform database, the earliest literature related to LAP and hypertension in Chinese adults that could be retrieved from databases establishment to August 2022. Two researchers independently screened all the retrieved literature according to the inclusion and exclusion criteria, and used the diagnostic research scale developed by Joanna Briggs Institute (JBI) to evaluate the literature quality of the selection, comparability, exposure evaluation and results of the study population. The sample size, gender, sensitivity, specificity and other information were extracted from the included literature. Stata 16.0 software was used for meta-analysis. Results ·A total of 6 articles were included, including five in English and one in Chinese. The JBI bias scores of the included articles ranged from 14 to 17 points, all of which were greater than 70% of the total score, so the biases could be considered small. The total number of samples included was 48 329, including 15 746 patients with hypertension. The results of meta-analysis showed that in the total population, the sensitivity of LAP in predicting hypertension was 0.50 (95%CI 0.35‒0.64), and the specificity was 0.78 (95%CI 0.66‒0.86); In women, the sensitivity was 0.48 (95%CI 0.32‒0.64), and the specificity was 0.77 (95%CI 0.64‒0.86); In males, the sensitivity was 0.56 (95%CI 0.39‒0.72), and the specificity was 0.64 (95%CI 0.49‒0.77). The area under the summary receiver operator characteristic curve (SROC curve) of the total population included was 0.70 (95%CI 0.66‒0.74), indicating that there was a certain correlation between LAP and hypertension. Conclusion ·In Chinese adult population, LAP is associated with hypertension to a certain extent.
MA Zhuoran, YUAN Ancai, JIANG Huiru, CHEN Xiaoyu, ZHANG Wei, PU Jun. Meta analysis of correlation between lipid accumulation product and hypertension in Chinese adults. Journal of Shanghai Jiao Tong University (Medical Science)[J], 2023, 43(4): 466-473 doi:10.3969/j.issn.1674-8115.2023.04.009
KAHN等［9］提出的脂质蓄积指数（lipid accumulation product，LAP）是结合腰围与三酰甘油（triacylglycerol，TAG）的结果，能够较为准确地反映内脏脂肪和中心性肥胖的情况，计算公式分别为男性LAP=［腰围（cm）-65］×TAG（mmol/L），女性LAP=［腰围（cm）-58］×TAG（mmol/L）。国内外研究［10-12］均发现LAP与心脑血管疾病有密切联系。对伊朗、美国、荷兰和德国的研究进行汇总分析后发现，LAP不但可以作为高血压的预测因子，还可以作为糖尿病和全因死亡率的预测因子［13］。美国第三次全国健康和营养调查（the Third National Health and Nutrition Examination Survey，NHANES Ⅲ）显示，LAP在识别成年人总胆固醇（total cholesterol）、高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）、低密度脂蛋白胆固醇（low-density lipoprotein cholesterol，LDL-C）等11个评估心血管风险因素方面的表现优于体质量指数（body mass index，BMI）［14］。日本中年男性LAP（OR=43.65，95%CI 4.33~4.09）相比于LDL-C/HDL-C（OR=1.88，95%CI 1.69~2.10）、TAGs/HDL-C（OR=2.65，95%CI 2.46~2.86），对高血压的识别能力更优（P<0.001）［15］。在我国内蒙古的男性中，与BMI（OR=2.80，95%CI 1.86~4.21）相比，LAP（OR=4.21，95%CI 2.78~6.38）与高血压风险之间的相关性更强（P<0.001）［16］。2017—2018年南京市5个区共纳入59 251人的慢性病防控社会因素调查研究［17］发现，随着LAP水平的升高，高血压的患病风险随之升高。
英文文献采用PubMed、Web of Science数据库进行检索，中文文献采用中国知网、万方数据知识服务平台数据库进行检索。检索时间从数据库建库到2022年8月。检索词设定为“高血压”“脂质蓄积指数”“hypertension”“LAP”“lipid accumulation product”。选定范围的文章的参考文献也被纳入补充范围。
Tab 1 Basic information and quality score of included literature
The first author
Research area
Study time
Hypertension definition
Research type
Total sample size
Number of patients with hypertension
Quality score/point
YAN
Pudong New Area, Shanghai
January, 2012‒March, 2013
Systolic blood pressure (SBP) ≥ 140 mmHg, diastolic blood pressure (DBP) ≥ 90 mmHg, or a history of oral antihypertensive medication
Cross-sectional study
2 092
1 066
15
SONG
Bengbu, Anhui Province
2018
SBP≥140 mmHg, DBP≥90 mmHg, or the subject reported with a medical history of antihypertensive medication
Cross-sectional study
1 777
433
14
WANG
Liaoning Province
2012
Blood pressure level of at least 140/90 mmHg, individuals who were on antihypertensive medications or a prior diagnosis of hypertension
Cross-sectional study
11 400
5 684
17
HUANG
Foshan, Fujian Province
2017
Prehypertension was defined as SBP 120‒139 mmHg and/or DBP 80‒89 mmHg, and hypertension was defined as SBP≥140 mmHg, DBP≥90 mmHg and/or a reported medical history of antihypertensive medication
Cross-sectional study
1 681
458
17
LEE
The Taiwan region
2022
Hypertension was defined as a self-reported history, SBP≥140 mmHg, or DBP≥90 mmHg during follow-up
Cohort study
21 466
3 157
16
LUO
Dalian, Liaoning Province
2011
Blood pressure≥140/90 mmHg and/or persons with confirmed hypertension and receiving treatment
MA Zhuoran was responsible for the design, draft writing, literature retrieval and data analysis. YUAN Ancai and CHEN Xiaoyu were responsible for literature quality evaluation. JIANG Huiru was responsible for literature retrieval. PU Jun and ZHANG Wei participated in the revision. All authors have read the last version of paper and consented for submission.
利益冲突声明
所有作者声明不存在利益冲突。
COMPETING INTERESTS
All authors disclose no relevant conflict of interests.
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