LAP May Predict Risk of Hyperuricemia and Gout

Lipid accumulation product had high potential in predicting the risk of gout/hyperuricemia in new research, offering a potentially modifiable risk factor for preventing gout.1

“Traditional metrics for evaluating obesity, such as Body Mass Index (BMI) and Waist Circumference (WC), have been widely utilized; however, they exhibit significant limitations in accurately reflecting the complex nature of adiposity and its associated health risks. In this context, the novel Lipid Accumulation Product (LAP), which integrates WC and fasting triglycerides (TG), emerges as a promising alternative. This innovative metric not only enhances the precision of obesity assessment but also serves as a potential indicator for cardiovascular diseases and metabolic syndrome, thereby highlighting the substantial implications of this research in advancing our understanding of obesity-related health outcomes2,” lead investigator Dexian Xian, The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China, and colleagues wrote.1

Xian and colleagues evaluated data from 10,871 people from the National Health and Nutrition Examination Survey whose data were entered between the years 2009–2018. Participants self-reported gout and hyperuricemia as measured by laboratory test data, and other relevant data for LAP were evaluated. The investigators determined the association between LAP and gout/hyperuricemia using multivariate logistic regression, restricted cubic spline and p-trend tests.

Xian and colleagues found that the prevalence of hyperuricemia was 20.9% and the prevalence of gout was 5.57%. Compared with the first quartile, the fourth quartile of LAP was associated with a 271% higher risk of hyperuricemia (OR, 3.711 [95% CI, 2.732–5.042]; P <.001) in a fully adjusted model. They found a similar association between continuous increase in LAP and hyperuricemia (OR, 2.441 [95% CI, 1.348–4.42]; P = .005), with P trends showing both < .001. Furthermore, they found that Radar cross-section (RCS) models suggested a significant non-linear, inverted U-shaped relationship between LAP and the risk of gout/hyperuricemia.

“In conclusion, the results of the present study confirmed the significant positive correlation between LAP and hyperuricemia/gout, suggesting that LAP can be used as a dynamic index for the detection of gout/hyperuricemia. Clinicians would be able to identify people at high risk for early diagnosis of gout/hyperuricemia by LAP, allowing targeted interventions to be implemented to reduce the risk of the latter. However, the specific molecular mechanism of this relationship remains unclear, and future studies should focus on elucidation of the biological link between LAP and hyperuricemia/gout, as well as evaluating the extent to which interventions to regulate LAP index can reduce the incidence of hyperuricemia/gout,” Xian and colleagues concluded.

Xian and colleagues noted limitations to the study, including the NHANES database source, which is a cross-sectional study. They stressed that the findings of this research should be verified be further research, and that the relationship cannot be called causal without randomized controlled trials or Mendelian randomization. Lastly, the method of self-reported gout may present a risk of retrospective bias.

REFERENCES

1. Xian D, Wang W, Li H, et al. Lipid accumulation product: A novel marker for gout and hyperuricemia. PLoS One. Published online May 20, 2025. doi.org/10.1371/journal.pone.0324139

2. Kahn HS. The lipid accumulation product is better than BMI for identifying diabetes: a population-based comparison. Diabetes Care. 2006;29(1):151–3. pmid:16373916