Lipid Accumulation Product (LAP)
The lipid accumulation product combines waist circumference and fasting triglycerides into a single number that flags excess central fat better than body mass index.
Plain English
Patient-Friendly Explanation
The lipid accumulation product, usually shortened to LAP, is a simple calculation that needs only a tape measure and a fasting blood test. It multiplies waist circumference by fasting triglycerides, with a small subtraction that differs between men and women: waist in centimetres minus 65 times triglycerides in millimoles per litre for men, and waist minus 58 times triglycerides for women. The logic is that two things rise together when the body is carrying more fat fuel than it can safely store - a bigger waist, which reflects visceral fat, and higher triglycerides, which reflect lipid spillover - so multiplying them captures the accumulation. In large population studies LAP identified people at cardiovascular risk better than body mass index, and it also predicts diabetes and metabolic syndrome. It costs nothing extra because both measurements are usually already being done, and unlike a scan it can be repeated as often as needed. It is not a diagnosis and the thresholds are population-specific, so it is best used alongside waist measurement, blood pressure and HbA1c rather than on its own.
Medical
Clinical Definition
Kahn introduced the lipid accumulation product in 2005 (BMC Cardiovascular Disorders 5:26) using the third National Health and Nutrition Examination Survey (9,180 adults, weighted to represent 100.05 million adults), defining LAP = (waist circumference in cm minus 65) x fasting triglycerides in mmol/L for men and (waist circumference minus 58) x triglycerides for women, the constants being the estimated population minimum waist circumferences; values at or below the constants are adjusted upward so the index cannot be non-positive. LAP is a continuous variable and outperformed body mass index for identifying adverse levels of 11 cardiovascular risk factors, correlating better with lipid variables, uric acid and resting heart rate, with equivalent correlation for blood pressure. It combines a measure of truncal adiposity with a marker of lipid overaccumulation from ectopic deposition in liver, skeletal muscle, heart and vessels, and is closely associated with insulin resistance. Subsequent studies and meta-analyses show good discrimination for metabolic syndrome, generally exceeding waist circumference, body mass index, waist-to-height ratio and waist-to-hip ratio and, in several populations, the visceral adiposity index, with a pooled performance that differs by sex; raised LAP has also been associated with incident diabetes, all-cause mortality in non-diabetic patients at high cardiovascular risk, and mortality in normal-weight postmenopausal women. Limitations are practical rather than conceptual: the fasting state is required, triglycerides also rise with alcohol intake, primary dyslipidaemia, oestrogen therapy and uncontrolled diabetes, so a single raised value should be interpreted with fasting glucose and HbA1c, and cut-offs must be taken from the relevant population rather than transplanted across ethnic groups.
Key Insight
Why It Matters
A big waist and a high fasting triglyceride tell the same story a scan would, and the two together - the LAP - are already most of what a metabolic risk assessment needs.
Sources
Reviewed against standard medical references.
Medically reviewed by
Family Physician & Registered Acupuncturist, Accord Medical Clinic. MBBS (NUS), Graduate Diploma in Family Medicine (NUS), Graduate Diploma in Acupuncture (Singapore College of TCM).
Last reviewed: September 2026
This page is general health education, not medical advice. Whether any treatment is appropriate for you is a decision made in consultation after assessment.
