title: Lipid accumulation product and visceral adiposity index are effective markers for identifying the metabolically obese normal-weight phenotype.
abstract: OBJECTIVE
  Studies have identified the metabolically obese normal-weight (MONW) phenotype, which carries increased risk of diabetes and cardiovascular disease. We aimed to investigate the ability of lipid accumulation product (LAP) and visceral adiposity index (VAI), two markers of visceral obesity, to identify the MONW phenotype.
  
  
  METHODS
  Normal-weight participants [body mass index (BMI) being of 18.5-23 kg/m(2)] (n = 3,552; 46.9 % men) in the 2009 nationwide China Health and Nutrition Survey were included in our analysis. Four different criteria that have been published were used to define the MONW phenotype. LAP and VAI were calculated according to published formula.
  
  
  RESULTS
  Receiver operating characteristic (ROC) curve analysis revealed that, regardless of the definition used to define MONW phenotype, both LAP [area under the ROC curve (AUC) ranging from 0.606 to 0.807 depending on the criteria used for MONW phenotype] and VAI (AUC ranging from 0.611 to 0.835 depending on the criteria used for MONW phenotype) outperformed anthropometric parameters including BMI, waist circumference, waist-to-hip ratio, and waist-to-height ratio for identifying MONW phenotype. Both LAP and VAI were strongly related to the MONW phenotype, irrespective of the criteria used to define the MONW phenotype. The associations between the 4th quartile of LAP and the MONW phenotype or between the 4th quartile of VAI and the MONW phenotype were consistently seen in various subgroups.
  
  
  CONCLUSIONS
  Our study demonstrates that both LAP and VAI are effective markers for identifying the Chinese adults with MONW phenotype.
authors.affiliation: Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Du
authors.affiliation: Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department of Endocrinology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. zhjh1205@hotmail.com.
authors.forename: Jianhua
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China. sunxx1984@gmail.com.
authors.forename: Xingxing
authors.initials: X
authors.lastname: Sun
mesh_terms: D050154:Adiposity; D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D002318:Cardiovascular Diseases; D002681:China; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000503:physiopathology*; D064237:Lipid Accumulation Product; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D009765:Obesity; D056128:Obesity, Abdominal; D010641:Phenotype; D012372:ROC Curve; D055105:Waist Circumference
keywords: Lipid accumulation product; Metabolically obese normal weight; Visceral adiposity index