Association between Lipid Accumulation Product and Cardiometabolic Multimorbidity in Adults Aged 50 Years and Older: Findings from the English Longitudinal Study of Ageing
Bibliographic record
Abstract
INTRODUCTION: The lipid accumulation product (LAP) is a sex-specific index that reflects visceral adiposity and lipid imbalance. This study aimed to investigate the longitudinal association between LAP and cardiometabolic multimorbidity (CMM) and to assess its value in risk prediction. METHODS: Data were analyzed from 3,348 individuals (mean age = 64 years; 54.9% female) enrolled in the English Longitudinal Study of Ageing who had no prior history of hypertension, coronary heart disease, diabetes, or stroke at baseline (wave 4: 2008-2009). LAP was calculated using waist circumference (cm) and fasting triglyceride levels (mmol/L) via standardized sex-specific formulas. CMM was operationally defined as the coexistence of two or more of the following cardiometabolic disorders by wave 10 (2021-2023): hypertension, cardiovascular disease, diabetes, or stroke. Odds ratios (ORs) with 95% confidence intervals (CIs) were derived using logistic regression models with multivariable adjustment, and model performance was evaluated using discrimination metrics. RESULTS: During follow-up spanning 12-15 years, 197 cases of CMM were recorded. Analysis using restricted cubic splines demonstrated a linear trend between LAP and CMM risk, with no evidence of nonlinearity (p = 0.23). Each one standard deviation rise in LAP was significantly associated with elevated odds of developing CMM (OR = 1.31; 95% CI: 1.16-1.49), which remained significant after adjusting for physical activity (OR = 1.30; 95% CI: 1.14-1.47). Trends were similar across LAP tertiles. Incorporating LAP into a model with conventional risk factors modestly improved discrimination (ΔC-index = 0.0064; p = 0.32), but significantly improved model fit (-2 log likelihood test, p < 0.001). CONCLUSION: Higher LAP was linearly and independently associated with increased risk of CMM in older adults. While the inclusion of LAP modestly improved model fit, its added value in enhancing risk discrimination beyond established cardiometabolic risk factors was limited in this cohort.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".