The accuracy of lipid accumulation product to predict metabolic syndrome in PCOS: a meta-analysis and comparative analysis with other indicators

Background: The diagnosis of metabolic syndrome (MetS) in patients with polycystic ovary syndrome (PCOS) is complex. Various indicators are utilized to predict MetS in clinical practice. Nonetheless, there is ongoing debate regarding which indicator possesses a higher predictive value. This study examines the accuracy of the lipid accumulation product (LAP) in screening for MetS among patients with PCOS and compares it with other indicators. Methods: A systematic literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library to identify eligible studies. Outcomes were pooled using the mean difference, odds ratio, and diagnostic accuracy parameters, (including sensitivity, specificity, and the area under the summary receiver operating characteristic (AUROC) curve. Comparative analysis was performed using the Z-test. Results: A meta-analysis of 11 studies comprising 3720 participants revealed that LAP was significantly elevated in PCOS patients with MetS, with a pooled MD of 2.52 units (P<0.001). LAP demonstrated a strong association with MetS, yielding a pooled OR of 34.31 (P<0.001). For the detection of MetS, LAP exhibited a pooled sensitivity of 87% (95% CI: 79%-92%), specificity of 84% (95% CI: 79%-89%), and an AUROC of 0.92 (95% CI: 0.89-0.94). The AUROC of LAP was significantly superior to that of body mass index, waist circumference, triglyceride levels, and abdominal volume index (P<0.001). Conclusion: LAP represent as a cost-effective, simple, and a better proxy indicator for screening MetS in the PCOS population. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42025638798.