Novel Lipid Biomarkers and Microvascular Complications in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis

Background: Emerging lipid-related biomarkers, including the Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Atherogenic Index of Plasma (AIP), have demonstrated potential in predicting metabolic disorders such as diabetes mellitus (DM) and associated microvascular complication...

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Main Authors: Diar Zooravar, Shayan Shojaei, Asma Mousavi, Pedram Soltani, Bahareh Shateri Amiri, Hanieh Radkhah
Format: Article
Language:English
Published: SAGE Publishing 2025-08-01
Series:Clinical Medicine Insights: Endocrinology and Diabetes
Online Access:https://doi.org/10.1177/11795514251365301
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author Diar Zooravar
Shayan Shojaei
Asma Mousavi
Pedram Soltani
Bahareh Shateri Amiri
Hanieh Radkhah
author_facet Diar Zooravar
Shayan Shojaei
Asma Mousavi
Pedram Soltani
Bahareh Shateri Amiri
Hanieh Radkhah
author_sort Diar Zooravar
collection DOAJ
description Background: Emerging lipid-related biomarkers, including the Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Atherogenic Index of Plasma (AIP), have demonstrated potential in predicting metabolic disorders such as diabetes mellitus (DM) and associated microvascular complications, particularly diabetic kidney disease (DKD) and diabetic retinopathy (DR). Objectives: This systematic review and meta-analysis aims to evaluate the association between these biomarkers and microvascular complications in individuals with DM, as well as to assess their diagnostic performance. Data sources and methods: A systematic literature search was performed in PubMed, Scopus, Embase, and Web of Science following PRISMA guidelines. Eligible studies examined the relationship between VAI, LAP, and AIP and microvascular complications in DM. The meta-analysis synthesized data using pooled weighted mean differences (WMDs) and area under the receiver operating characteristic curve (AUC) values to evaluate the predictive utility of these biomarkers for DKD and DR. Results: A total of 23 studies were included. Patients with DKD had significantly higher levels of LAP (WMD: 12.67; 95% CI: 7.83–17.51; P  < .01), AIP (WMD: 0.11; 95% CI: 0.03–0.19; P  < .01), and VAI (WMD: 0.63; 95% CI: 0.38–0.89; P  < .01) compared to those without DKD. Additionally, each 1-unit increase in LAP (OR: 1.005; 95% CI: 1.003–1.006; P  < .01), AIP (OR: 1.08; 95% CI: 1.04–1.12; P  < .01), and VAI (OR: 1.05; 95% CI: 1.03–1.07; P  < .01) was associated with an elevated risk of DKD. In contrast, no significant associations were identified between these biomarkers and DR. The diagnostic performance of VAI, LAP, and AIP was limited for both DR and DKD, with low discriminatory power. Conclusion: VAI, LAP, and AIP are significant predictors of DKD in individuals with DM but exhibit limited relevance for the detection of DR. Although these biomarkers show potential in identifying DKD risk, their overall diagnostic accuracy for DKD and DR remains modest, underscoring the need for further studies to enhance their clinical applicability.
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spelling doaj-art-8a342e9434b94d1c81df33ae37b512c72025-08-20T03:43:40ZengSAGE PublishingClinical Medicine Insights: Endocrinology and Diabetes1179-55142025-08-011810.1177/11795514251365301Novel Lipid Biomarkers and Microvascular Complications in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysisDiar Zooravar0Shayan Shojaei1Asma Mousavi2Pedram Soltani3Bahareh Shateri Amiri4Hanieh Radkhah5School of Medicine, Iran University of Medical Sciences, Tehran, IranTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, IranTehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, IranDepartment of Internal Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, IranDepartment of Internal Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, IranDepartment of Internal Medicine, Sina Hospital, Tehran University of Medical Sciences, IranBackground: Emerging lipid-related biomarkers, including the Visceral Adiposity Index (VAI), Lipid Accumulation Product (LAP), and Atherogenic Index of Plasma (AIP), have demonstrated potential in predicting metabolic disorders such as diabetes mellitus (DM) and associated microvascular complications, particularly diabetic kidney disease (DKD) and diabetic retinopathy (DR). Objectives: This systematic review and meta-analysis aims to evaluate the association between these biomarkers and microvascular complications in individuals with DM, as well as to assess their diagnostic performance. Data sources and methods: A systematic literature search was performed in PubMed, Scopus, Embase, and Web of Science following PRISMA guidelines. Eligible studies examined the relationship between VAI, LAP, and AIP and microvascular complications in DM. The meta-analysis synthesized data using pooled weighted mean differences (WMDs) and area under the receiver operating characteristic curve (AUC) values to evaluate the predictive utility of these biomarkers for DKD and DR. Results: A total of 23 studies were included. Patients with DKD had significantly higher levels of LAP (WMD: 12.67; 95% CI: 7.83–17.51; P  < .01), AIP (WMD: 0.11; 95% CI: 0.03–0.19; P  < .01), and VAI (WMD: 0.63; 95% CI: 0.38–0.89; P  < .01) compared to those without DKD. Additionally, each 1-unit increase in LAP (OR: 1.005; 95% CI: 1.003–1.006; P  < .01), AIP (OR: 1.08; 95% CI: 1.04–1.12; P  < .01), and VAI (OR: 1.05; 95% CI: 1.03–1.07; P  < .01) was associated with an elevated risk of DKD. In contrast, no significant associations were identified between these biomarkers and DR. The diagnostic performance of VAI, LAP, and AIP was limited for both DR and DKD, with low discriminatory power. Conclusion: VAI, LAP, and AIP are significant predictors of DKD in individuals with DM but exhibit limited relevance for the detection of DR. Although these biomarkers show potential in identifying DKD risk, their overall diagnostic accuracy for DKD and DR remains modest, underscoring the need for further studies to enhance their clinical applicability.https://doi.org/10.1177/11795514251365301
spellingShingle Diar Zooravar
Shayan Shojaei
Asma Mousavi
Pedram Soltani
Bahareh Shateri Amiri
Hanieh Radkhah
Novel Lipid Biomarkers and Microvascular Complications in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis
Clinical Medicine Insights: Endocrinology and Diabetes
title Novel Lipid Biomarkers and Microvascular Complications in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis
title_full Novel Lipid Biomarkers and Microvascular Complications in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis
title_fullStr Novel Lipid Biomarkers and Microvascular Complications in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis
title_full_unstemmed Novel Lipid Biomarkers and Microvascular Complications in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis
title_short Novel Lipid Biomarkers and Microvascular Complications in Patients with Diabetes Mellitus: A Systematic Review and Meta-analysis
title_sort novel lipid biomarkers and microvascular complications in patients with diabetes mellitus a systematic review and meta analysis
url https://doi.org/10.1177/11795514251365301
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