Dobiásová M
Fyziologický ustav Akademie vĕd Ceské republiky,
Vnitr Lek. 2006 Jan;52(1):64-71.
Various indices have been used for the diagnosis and prognosis of cardiovascular disease (CVD). Atherogenic index of plasma (AIP) is a logarithmically transformed ratio of molar concentrations of triglycerides to HDL-cholesterol. The strong correlation of AIP with lipoprotein particle size may explain its high predictive value. Here we summarize data on AIP calculated in 8394 subjects from 6 population and clinical studies.
AIP values increase with increasing CV risk. Thus umbilical cord, young children, healthy women have values below 0.1 while men and subjects with CV risk factors such as hypertension, diabetes, dyslipidemia have increasing values up to 0.4. Based on these data we suggest that AIP values of -0.3 to 0.1 are associated with low, 0.1 to 0.24 with medium and above 0.24 with high CV risk. In the population study men had higher AIP values than women. In a cohort undergoing coronary angiography AIP, in model that included age, BMI, waist circumference, type 2. DM, blood pressure, smoking, TG, TC, LDL-C, apoB, HDL-C, and TC/HDL-C, AIP was the best predictor of positive findings. AIP was also a highly sensitive marker of differences of lipoprotein profiles in families of patients with premature myocardial infarction and control families. Treatment with ciprofibrate, and combination of statin and niacin dramatically decreased AIP. Combination with hypoglycemic therapy that included pioglitazone decreased AIP in patiens with type 2. diabetes.
AIP can be easily calculated from standard lipid profile. As a marker of lipoprotein particle size it adds predictive value beyond that of the individual lipids, and/or TC/HDL-C ratio.
多种指标已被用于心血管疾病(CVD)的诊断和预后评估。血浆致动脉粥样硬化指数(AIP)是甘油三酯与高密度脂蛋白胆固醇摩尔浓度的对数转换比值。AIP与脂蛋白颗粒大小的强相关性可能解释了其较高的预测价值。在此,我们总结了来自6项人群和临床研究的8394名受试者的AIP数据。
AIP值随心血管疾病风险增加而升高。因此,脐带血、幼儿、健康女性的值低于0.1,而男性以及患有高血压、糖尿病、血脂异常等心血管疾病风险因素的受试者的值则升高至0.4。基于这些数据,我们建议AIP值在-0.3至0.1之间与低心血管疾病风险相关,0.1至0.24之间与中等风险相关,高于0.24与高心血管疾病风险相关。在人群研究中,男性的AIP值高于女性。在一项接受冠状动脉造影的队列研究中,在包含年龄、体重指数、腰围、2型糖尿病、血压、吸烟、甘油三酯、总胆固醇、低密度脂蛋白胆固醇、载脂蛋白B、高密度脂蛋白胆固醇以及总胆固醇/高密度脂蛋白胆固醇的模型中,AIP是阳性结果的最佳预测指标。AIP也是早发心肌梗死患者家族和对照家族脂蛋白谱差异的高度敏感标志物。环丙贝特治疗以及他汀类药物与烟酸联合使用可显著降低AIP。2型糖尿病患者采用包括吡格列酮在内的降糖治疗联合用药可降低AIP。
AIP可根据标准血脂谱轻松计算得出。作为脂蛋白颗粒大小的标志物,它除了具有单个脂质和/或总胆固醇/高密度脂蛋白胆固醇比值的预测价值外,还增加了预测价值。