Lipid accumulation products and endometriosis: A population-based study from NHANES

Jing Zhang, Zhang J, Guo H, Huiwen Guo, Zhigang Zhou, Zhou Z
International Journal of Gynecology & Obstetrics · 2025 · vol. 172(2) , pp. 1211–1220 · doi:10.1002/ijgo.70470 · PMID:40820588 · W4413295019
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This study found that higher lipid accumulation product (LAP) levels were positively associated with an increased risk of endometriosis in a US population-based sample, with LAP showing better diagnostic ability than BMI.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-16 · read from full text ⓘ

This cross-sectional population-based study used NHANES data from 1999–2006 (1711 women; 150 diagnosed with endometriosis) to examine the association between lipid accumulation product (LAP), calculated from waist circumference and triglycerides, and endometriosis using weighted logistic regression with sensitivity and subgroup analyses, plus ROC/AUC to assess diagnostic performance. Higher LAP was positively associated with endometriosis in fully adjusted models, with odds ratios of 1.874 for log-LAP and 3.474 for the highest LAP quartile, and sensitivity and subgroup analyses reported consistent results. LAP’s diagnostic discrimination was modest, with an AUC of 0.599 compared with 0.525 for BMI, and the analysis is limited by the cross-sectional design using NHANES data. This paper is centrally about endometriosis — it investigates whether LAP is associated with diagnosed endometriosis and evaluates LAP’s potential as a biomarker.

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Abstract

OBJECTIVE: To investigate the association between lipid accumulation product (LAP) and endometriosis using data from the National Health and Nutrition Examination Survey (NHANES), because lipid metabolism alterations and obesity have been implicated in the pathophysiology of endometriosis. METHODS: This cross-sectional study used data from NHANES (1999-2006) to assess the relationship between LAP, derived from waist circumference and triglycerides, and endometriosis. Weighted logistic regression models were used to detect the relationship. Sensitivity analysis and subgroup analyses were also conducted to assess the robustness of the association, and receiver operating characteristics curve analysis and area under the curve were performed to evaluate LAP's diagnostic ability for endometriosis. RESULTS: The analysis included 1711 women, of whom 150 were diagnosed with endometriosis, resulting in a prevalence of 10.73%. Logistic regression models indicated that higher LAP levels were positively associated with an increased risk of endometriosis. The odds ratio (OR) for log-LAP and the highest quartile were 1.874 (95% confidence interval [CI] 1.361-2.581, P < 0.001) and 3.474 (95% CI 1.616-7.469, P < 0.001) in the fully adjusted model. Sensitivity analysis showed consistent results, and subgroup analyses confirmed the stability of this association across different groups. The diagnostic performance of LAP was higher, with an AUC of 0.599, compared with 0.525 for body mass index. CONCLUSION: This study is the first to demonstrate an association between LAP and endometriosis in a large, nationally representative sample of US women. LAP may serve as an accessible, non-invasive biomarker for identifying women at risk for endometriosis, offering potential benefits for early diagnosis and management.
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Abstract

Objective To investigate the association between lipid accumulation product (LAP) and endometriosis using data from the National Health and Nutrition Examination Survey (NHANES), because lipid metabolism alterations and obesity have been implicated in the pathophysiology of endometriosis.

Methods

This cross-sectional study used data from NHANES (1999–2006) to assess the relationship between LAP, derived from waist circumference and triglycerides, and endometriosis. Weighted logistic regression models were used to detect the relationship. Sensitivity analysis and subgroup analyses were also conducted to assess the robustness of the association, and receiver operating characteristics curve analysis and area under the curve were performed to evaluate LAP's diagnostic ability for endometriosis.

Results

The analysis included 1711 women, of whom 150 were diagnosed with endometriosis, resulting in a prevalence of 10.73%. Logistic regression models indicated that higher LAP levels were positively associated with an increased risk of endometriosis. The odds ratio (OR) for log-LAP and the highest quartile were 1.874 (95% confidence interval [CI] 1.361–2.581, P < 0.001) and 3.474 (95% CI 1.616–7.469, P < 0.001) in the fully adjusted model. Sensitivity analysis showed consistent results, and subgroup analyses confirmed the stability of this association across different groups. The diagnostic performance of LAP was higher, with an AUC of 0.599, compared with 0.525 for body mass index.

Conclusion

This study is the first to demonstrate an association between LAP and endometriosis in a large, nationally representative sample of US women. LAP may serve as an accessible, non-invasive biomarker for identifying women at risk for endometriosis, offering potential benefits for early diagnosis and management. CONFLICT OF INTEREST STATEMENT The authors have no conflicts of interest. DATA AVAILABILITY STATEMENT Data from the National Health and Nutrition Examination Survey (NHANES) 1999–2006 are publicly available online (https://www.cdc.gov/nchs/nhanes/index.htm).

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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