血浆致动脉粥样硬化指数（AIP）：绝经后妇女冠心病的一种新的预测指标。
Atherogenic index of plasma (AIP): a novel predictive indicator for the coronary artery disease in postmenopausal women.
机构信息
Department of Cardiology, First Clinical Medical College & First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, People's Republic of China.
Cadre Ward, First Clinical Medical College & First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, People's Republic of China.
出版信息
Lipids Health Dis. 2018 Aug 22;17(1):197. doi: 10.1186/s12944-018-0828-z.
BACKGROUND
Dyslipidemia is one of the most important factors for coronary artery disease (CAD). Atherogenic index of plasma (AIP) is a novel indicator involved in dyslipidemia. However, the relation between AIP and CAD in postmenopausal women remains unclear. We hypotheses that AIP is a strong predictive indicator of CAD in postmenopausal women.
METHODS
A propensity score matching case-control study including 348 postmenopausal CAD cases and 348 controls was conducted in the present study.
RESULTS
Compared with controls, CAD patients had higher levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (APOB), but lower high-density lipoprotein cholesterol (HDL-C) and apolipoprotein A-1 (APOA-1). The values of nontraditional lipid profiles, including non-HDL-C, TC/HDL-C, LDL-C/HDL-C, non-HDL-C/HDL-C (atherogenic index, AI), TC∗TG∗LDL/HDL-C (lipoprotein combine index, LCI), log(TG/HDL-C) (atherogenic index of plasma, AIP) and APOB/APOA-1 were all significantly higher in the CAD patients. The results of Pearson correlation analyses showed AIP was positively and significantly correlated with TC (r = 0.092, P < 0.001), TG (r = 0.775, P = 0.015), APOB (r = 0.140, P < 0.001), non-HDL-C (r = 0.295, P < 0.001), TC/HDL-C (r = 0.626, P < 0.001), LDL-C/HDL-C (r = 0.469, P < 0.001), AI (r = 0.626, P < 0.001), LCI (r = 0.665, P < 0.001), APOB/APOA-1(r = 0.290, P < 0.001) and was negatively correlated with APOA-1 (r = - 0.278, P < 0.001) and HDL-C (r = - 0.665, P < 0.001). In the multivariate logistic regression analysis, AIP was an independent predictor of CAD. After adjusting for the traditional clinical prognostic factors including diabetes and hypertension, we found AIP could be an independent risk factor for CAD (odds ratio [OR], 3.290; 95% confidence interval [CI], 1.842-5.877, P < 0.001). After adjusting for multiple clinical factors include diabetes, hypertension, smoking, heart ratio, fasting blood glucose, we found AIP also could a powerful risk factor, OR = 3.619, 95%CI (2.003-6.538), P < 0.001.
CONCLUSION
The present study indicated that AIP might be a strong marker for predicting the risk of CAD in postmenopausal women.
背景
血脂异常是冠心病（CAD）最重要的危险因素之一。血浆致动脉粥样硬化指数（AIP）是一种新的血脂异常指标。然而，绝经后妇女的 AIP 与 CAD 之间的关系尚不清楚。我们假设 AIP 是绝经后妇女 CAD 的一个强有力的预测指标。
方法
本研究包括 348 例绝经后 CAD 病例和 348 例对照，采用倾向评分匹配病例对照研究。
结果
与对照组相比，CAD 患者的总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和载脂蛋白 B（APOB）水平较高，而高密度脂蛋白胆固醇（HDL-C）和载脂蛋白 A-1（APOA-1）水平较低。非传统血脂谱指标，包括非高密度脂蛋白胆固醇（non-HDL-C）、TC/HDL-C、LDL-C/HDL-C、非高密度脂蛋白胆固醇/高密度脂蛋白胆固醇（致动脉粥样硬化指数，AI）、TCTGLDL/HDL-C（脂蛋白组合指数，LCI）、log（TG/HDL-C）（血浆致动脉粥样硬化指数，AIP）和 APOB/APOA-1 在 CAD 患者中均显著升高。Pearson 相关分析结果显示，AIP 与 TC（r=0.092，P<0.001）、TG（r=0.775，P=0.015）、APOB（r=0.140，P<0.001）、非高密度脂蛋白胆固醇（r=0.295，P<0.001）、TC/HDL-C（r=0.626，P<0.001）、LDL-C/HDL-C（r=0.469，P<0.001）、AI（r=0.626，P<0.001）、LCI（r=0.665，P<0.001）、APOB/APOA-1（r=0.290，P<0.001）呈正相关，与 APOA-1（r=-0.278，P<0.001）和高密度脂蛋白胆固醇（r=-0.665，P<0.001）呈负相关。多因素 logistic 回归分析显示，AIP 是 CAD 的独立预测因子。在调整糖尿病和高血压等传统临床预后因素后，我们发现 AIP 是 CAD 的独立危险因素（比值比[OR]，3.290；95%置信区间[CI]，1.842-5.877，P<0.001）。在调整包括糖尿病、高血压、吸烟、心脏比值、空腹血糖在内的多种临床因素后，我们发现 AIP 仍然是一个强有力的危险因素，OR=3.619，95%CI（2.003-6.538），P<0.001。
结论
本研究表明，AIP 可能是预测绝经后妇女 CAD 风险的一个强有力的标志物。
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