Associations Between Lipid Accumulation Product, Visceral Adiposity Index, and Arterial Stiffness: Insights from NHANES 2005-2018

Background Arterial stiffness (AS) serves as a major indicator of vascular aging and is closely associated with cardiovascular disease, diabetes and cerebrovascular disorders. While carotid-femoral pulse wave velocity (cfPWV) is the gold standard for measuring AS, its clinical use is limited by equipment requirements. Estimated pulse wave velocity (ePWV) offers a feasible alternative. Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI) are newer indices that better capture visceral fat and its metabolic effects, but their relationship with AS remains underexplored. Objective This study examines the associations between LAP, VAI, and ePWV using NHANES data from 2005–2018, exploring potential threshold effects and demographic moderating factors. Methods Data from 9,984 adults aged 20–65 were analyzed. ePWV was derived from age and blood pressure. LAP and VAI were calculated using established formulas. Regression models assessed the associations between these indices and ePWV, with subgroup analyses by age, gender, and health status. Results Both LAP and VAI were positively associated with ePWV. LAP showed a stronger effect than VAI, with a significant U-shaped relationship, and the threshold effect at LAP was 2.676. Subgroup analysis revealed stronger associations in younger adults and women. Conclusion LAP is a more reliable marker of arterial stiffness than VAI, particularly for younger individuals and women. The study underscores LAP's clinical utility in predicting vascular aging and cardiovascular risk.