Abstract
BACKGROUND: The rising rates of obesity and Sarcopenia have attracted considerable academic interest. The Lipid Accumulation Product (LAP) serves as an indicator of abdominal obesity and cardiovascular risk; however, its association with Sarcopenia remains unexplored. The present study explores the relationship between LAP and Sarcopenia, with a focus on the intermediary function of diabetes in this association. METHODS: Cross-sectional data from 10,065 adults, collected through NHANES from 1999 to 2018, were analyzed. Multivariate logistic regression models were used to determine the odds ratio (OR) between LAP and Sarcopenia, and mediation analysis assessed diabetes's mediating effect on LAP-related Sarcopenia. RESULTS: This study included a cohort of 10,065 participants aged 20 years and older, among whom 1,153 were diagnosed with Sarcopenia. In a fully adjusted model, the LAP exhibited a positive association with the prevalence of Sarcopenia (OR = 2.57, 95% CI = 1.46-4.50, P < 0.001). When LAP was transformed from a continuous to a categorical variable, higher LAP levels were associated with an increased prevalence of Sarcopenia compared to the lowest LAP quartile (OR = 4.70, 95% CI = 1.81-12.16, P < 0.001). The application of restricted cubic spline analysis revealed a curvilinear relationship between LAP and Sarcopenia prevalence, with a significant inflection point at LAP = 4. Subgroup and sensitivity analyses confirmed the consistent association between LAP and Sarcopenia. Additionally, diabetes mellitus was identified as a partial mediator in this association, accounting for a mediation proportion of 31.1%. CONCLUSION: The study reveals a significant correlation between elevated levels of LAP and an increased prevalence of Sarcopenia, with diabetes identified as a mediating factor in this association. Further research is required to investigate the underlying mechanisms.