Evaluation of the lipid accumulation product for MASLD risk stratification in type 2 diabetes: establishing sex-specific thresholds and clinical utility
Authors' conclusion
log10LAP is a robust linear predictor of MASLD in T2DM. Implementing tailored thresholds provides superior diagnostic precision and clinical net benefit, particularly for younger and non-obese populations, supporting its use as a prioritized non-invasive screening tool.
Study context
- Population
- Inpatients with T2D
- Participants
- 495 inpatients
- Outcome
- Prevalent MASLD: association with log10LAP and sex-specific diagnostic thresholds
Methodological detailsBoruta feature selection, ROC analysis, 1,000-run stratified bootstrapping (internal validation), external validation in NHANES cohort, restricted cubic splines, decision curve analysis
- Boruta feature selection
- ROC analysis
- 1,000-run stratified bootstrapping (internal validation)
- External validation in NHANES cohort
- Restricted cubic splines
- Decision curve analysis
Performance
As reported in the abstract
MASLD
| Test or model | Cut-off, men | Cut-off, women | PPV |
|---|---|---|---|
| Lipid accumulation product (LAP) | 20.4 | 27.0 | 85.93% |
Lipid accumulation product (LAP)
Cut-off, men20.4
Cut-off, women27.0
PPV85.93%
- log10LAP independently associated with MASLD, OR
- 1.83 (95% CI 1.43-2.35)
Further findings
Clinical net benefit (decision curve analysis (DCA))
- Consistently higher net benefit for LAP-based model vs "screen-all" at threshold probabilities > 0.20
Discrimination by subgroup
- AUC, age < 55 years
- 0.855
- AUC, non-obese
- 0.711
External validation, NHANES cohort (N = 630)
- Consistent independent associations between LAP and MASLD risk
- P < 0.05
Original publication
Evaluation of the lipid accumulation product for MASLD risk stratification in type 2 diabetes: establishing sex-specific thresholds and clinical utility. Cardiovasc Diabetol. Published 11 May 2026. doi:10.
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