LIPID ACCUMULATION PRODUCT OR LAP AS AN UP-TO-DATE CLINICAL BIOCHEMICAL MARKER OF HUMAN OBESITY
Obesity is a grave medical and social problem causing significant hazards for human health due to frequent occurrence of grave concomitant diseases. Visceral obesity is considered to be the most hazardous. Contemporary diagnostics which allows to reveal visceral obesity both during screening examinations of people who are considered to be conditionally healthy and in patients who suffer from cardiovascular diseases is becoming a very promising trend both in primary and secondary prevention. The review focuses on an up-to-date marker used to detect visceral obesity, namely, lipid accumulation product or LAP. This index was first introduced by Kahn H.S. in 2005 and is calculated on the basis of two variables, waist circumference (cm) and fasting concentration of triglycerides (mmol/l). When a biochemical and an anthropometric parameter are applied simultaneously to calculate LAP, it allows not only to assess how fats are distributed in a body but also to reflect functional state of fat tissues. LAP index is widely used as a marker showing there are metabolic disorders in a body (metabolic syndrome, diabetes, resistance to insulin, or nonalcoholic fatty liver disease) and as a cardiovascular diseases predictor. Besides, LAP index, when used to identify obesity phenotype, allows to assign people with overweight into a "metabolically healthy" category or "metabolically ill" one and to reveal patients suffering from metabolic obesity among people with normal body weight. A lot of research revealed that LAP index had a very good diagnostic and predictive potential as regards metabolic and cardiovascular diseases and was a more precise marker of cardio-metabolic risks than conventional anthropometric parameters. The review highlights LAP value ranges, its sex and age peculiarities, as well as a character and an extent to which LAP values change in case of certain diseases. It also dwells on advantages and drawbacks of LAP practical application.