title: The lipid accumulation product is associated with impaired glucose tolerance in PCOS women.
abstract: BACKGROUND
  Women with polycystic ovary syndrome (PCOS) frequently suffer from metabolic disturbances. Lipid accumulation product (LAP) is an emerging cardiovascular risk factor. We aimed to investigate the association of LAP with impaired glucose tolerance (IGT) in PCOS and control women.
  
  
  METHODS
  The LAP was calculated as [waist circumference (centimeters) - 58] × [triglycerides (millimoles per liter)] in 392 PCOS and 140 body mass index (BMI)-matched control women within the same age range. Metabolic, endocrine, and anthropometric measurements and oral glucose tolerance tests were performed.
  
  
  RESULTS
  PCOS women had significantly higher LAP levels than control women in age-adjusted analyses [22.2 (10.9-46.2) and 18.2 (10.7-36.3), respectively, P = 0.001). In PCOS and control women, age, BMI, blood pressure, fasting and stimulated glucose, fasting and stimulated insulin, and free testosterone progressively increased, whereas SHBG decreased across LAP quartiles. In PCOS and control women, receiver operating characteristic curve analysis revealed that the best cutoff value for LAP to define the presence of IGT was 44.1 and 41.8, respectively [sensitivity 79.5%, specificity 80.5%, and area under the curve (AUC) 0.86 and sensitivity 82.3%, specificity 90.5%, and AUC 0.86, respectively]. In PCOS and control women, receiver operating characteristic curve analyses for BMI (0.77 and 0.54, respectively) and waist circumference (0.80 and 0.72, respectively) to define IGT revealed lower AUC. Odds ratios for IGT for PCOS women in the highest LAP, BMI, and waist-to-hip ratio quartile were 41.81 (5.52-316.54), 10.24 (2.94-35.63), and 18.45 (4.19-81.30), respectively, when compared with PCOS women in the lowest LAP, BMI, and WHR quartile, respectively.
  
  
  CONCLUSIONS
  LAP is an easily obtainable and cheap marker associated with IGT in PCOS and control women.
authors.affiliation: Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Metabolism, Auenbruggerplatz 15, 8036 Graz, Austria. elisabeth.wehr@medunigraz.at
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Wehr
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Gruber
authors.forename: Albrecht
authors.initials: A
authors.lastname: Giuliani
authors.forename: Reinhard
authors.initials: R
authors.lastname: Möller
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Pieber
authors.forename: Barbara
authors.initials: B
authors.lastname: Obermayer-Pietsch
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D005260:Female; D018149:Glucose Intolerance / Q000378:metabolism* / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D011085:Polycystic Ovary Syndrome / Q000378:metabolism* / Q000503:physiopathology; D012372:ROC Curve; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood*; D055105:Waist Circumference / Q000502:physiology*
chemical_list: D014280:Triglycerides