Lipid accumulation product (LAP) as a criterion for the identification of the healthy obesity phenotype in postmenopausal women

Obesity and its complications constitute a major health problem in postmenopausal women. The identification of the obesity phenotype, especially that of metabolically healthy obese (MHO) patients, is a necessary part of obesity treatment protocols. There are several methods to define MHO, but unfortunately, all of them are arbitrary and inconsistent. The aim of this work was to determine whether lipid accumulation product (LAP) could be used as a marker of the MHO phenotype in postmenopausal women. A sample of 345 Polish postmenopausal women aged 50-60 years old participated in the study. Participants were classified as obese when their BMI was > 27. Receiver operating characteristic curve analysis was performed to estimate the best cutoff for the LAP index value to identify postmenopausal women without metabolic syndrome components. We found that the best cutoff value was LAP ≤ 29.9, and this value was used to define MHO individuals. With this definition, the identification of MHO individuals could be made when both of the following criteria were met: LAP index ≤ 29.9 and no arterial hypertension (SBP < 130 mm Hg, DBP < 85 mm Hg). The anthropometric and body fat distribution measurements, as well as the metabolic characteristics of MHO women identified according to the above definition, were compared with those of MHO women identified by two other methods in the literature. These methods and our definition identified similar proportions of MHO women ranging from 11.6% to 16.9%. We found that MHO women identified by all of the definitions used in this study possessed a similar metabolic status, and they did not differ in anthropometric indices or body fat distribution measurements. We concluded that the combination of LAP estimation and arterial blood pressure measurement appear to constitute a useful method for identifying the MHO phenotype in postmenopausal women.