Association between lipid accumulation product and stroke incidence: A national cohort study based on CHARLS.

Abstract

Background: Several studies have identified a correlation between the lipid accumulation product (LAP) and cardiovascular disease. However, there have been few large cohort studies on the LAP and the risk of stroke in middle-aged and elderly Chinese individuals.

Objective: This study aimed to explore the association between LAP and the risk of stroke in the middle-aged and elderly population in China.

Methods: The study included subjects aged ≥45 years who were participants in the China Health and Retirement Longitudinal Study (CHARLS) and had no history of stroke at baseline. Basic information, physical findings, laboratory data, and follow-up results in 2013, 2015, 2018, and 2020 were collected for the study participants. The correlation between LAP and stroke onset was examined using a Cox proportional hazards regression model and the dose-response relationship between LAP and stroke onset by restricted cubic spline analysis. Subgroup analyses were also performed.

Results: The 6,726 study participants had a median age of 60 years, and 498 (7.40 %) had new strokes. Cox proportional hazards regression showed that for every standard deviation increase in LAP, the risk of stroke increased by 27.9 % (HR= 1.279, 95 % CI=1.086-1.505, P = 0.003). Restricted cubic spline analysis revealed a nonlinear association between LAP and the risk of stroke, and the inflection point was identified at a LAP of 28.140 (P for nonlinear <0.001). Subgroup analyses showed the same positive correlation between LAP and stroke incidence regardless of age, sex, hypertension, or diabetes. The association between LAP and stroke was also independent of heart disease, smoking, and drinking.

Conclusions: This study found a positive nonlinear relationship between the LAP and the risk of stroke, with the incidence of stroke increasing when the LAP was >28.140. These findings enable LAP to play a supportive role in screening of the population at high risk of stroke.