Lipid accumulation product and its association between new onset stroke among middle age and elderly population

Abstract Background The lipid accumulation product (LAP), which integrates waist circumference and triglyceride levels, is an effective indicator of excessive fat accumulation. This study aimed to investigate the association between LAP and the risk of incident stroke among adults aged 45 years and older. Methods Using data from the China Health and Retirement Longitudinal Study (CHARLS), a total of 9,060 participants aged ≥ 45 years without a prior history of stroke were included. LAP was categorized into quartiles (Q1–Q4). Cox proportional hazards models were applied to evaluate the association between LAP and incident stroke. Model 1 was adjusted for sex, age, and residence, while Model 2 was further adjusted for education level, smoking, alcohol consumption, body mass index, diabetes, hypertension, dyslipidemia, and history of cardiovascular disease. Results During follow-up, 1,300 incident stroke cases were identified among the 9,060 participants. Cox regression analysis showed that, compared with the lowest LAP quartile, participants in the higher quartile had a significantly increased risk of incident stroke. The association remained robust after excluding participants using lipid-lowering medications in sensitivity analyses. Subgroup analyses demonstrated consistent associations across age, sex, smoking status, alcohol consumption, hypertension, and diabetes. Kaplan–Meier curves across LAP quartiles indicated a significantly higher cumulative incidence of stroke in the high-LAP group. Conclusions Higher LAP was positively associated with an increased risk of incident stroke among adults aged 45 years and older. LAP may serve as a complementary indicator for stroke risk screening in community populations.