Nam Ji Sun, Kim Min Kyung, Nam Joo Young, Park Kahui, Kang Shinae, Ahn Chul Woo, Park Jong Suk
Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.
Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, South Korea.
Lipids Health Dis. 2020 Jul 2;19(1):157. doi: 10.1186/s12944-020-01317-4.
Dyslipidemia is a well-known risk factor for cardiovascular disease (CVD). Recently, atherogenic index of plasma (AIP) has been proposed as a novel predictive marker for CVD, and few cross sectional studies have demonstrated a relationship between AIP and coronary artery disease. The present study investigated the association between AIP and the progression of coronary artery calcification (CAC) in Korean adults without CVD.
A total of 1124 participants who had undergone CAC measurement at least twice by multi-detector computed tomography (CT) at a health check-up center were enrolled. Their anthropometric measurements and various cardiovascular risk factors were assessed. AIP was defined as the base 10 logarithm of the ratio of the concentration of triglyceride (TG) to high-density lipoprotein-cholesterol (HDL-C). CAC progression was defined as either incident CAC in a CAC-free population at baseline, or an increase of ≥2.5 units between the square roots of the baseline and follow-up coronary artery calcium scores (CACS) in subjects with detectable CAC at baseline.
CAC progression was observed in 290 subjects (25.8%) during the mean follow-up of 4.2 years. All subjects were stratified into three groups according to AIP. There were significant differences in cardiovascular parameters among groups at baseline. The follow-up CAC and the incidence of CAC progression increased gradually with rising AIP tertiles. In logistic regression analysis, the odds ratio for CAC progression was 2.27 when comparing the highest to the lowest tertile of AIP (95% CI: 1.61-3.19; P for trend < 0.01). However, this association was attenuated after adjustment for multiple risk factors (P for trend = 0.67).
There is a significant correlation between AIP and the progression of CAC in subjects without CVD. Although AIP was not an independent predictor of CAC progression, AIP should be considered when estimating the current as well as future CVD risk, along with other traditional risk factors.
血脂异常是心血管疾病(CVD)的一个众所周知的危险因素。最近,血浆致动脉粥样硬化指数(AIP)已被提议作为CVD的一种新型预测标志物,并且很少有横断面研究证明AIP与冠状动脉疾病之间的关系。本研究调查了韩国无CVD成年人中AIP与冠状动脉钙化(CAC)进展之间的关联。
共有1124名在健康检查中心至少接受过两次多排螺旋计算机断层扫描(CT)进行CAC测量的参与者被纳入研究。评估了他们的人体测量指标和各种心血管危险因素。AIP定义为甘油三酯(TG)浓度与高密度脂蛋白胆固醇(HDL-C)浓度之比的常用对数。CAC进展定义为基线时无CAC人群中出现的新发CAC,或基线时可检测到CAC的受试者在基线和随访冠状动脉钙化评分(CACS)平方根之间增加≥2.5个单位。
在平均4.2年的随访期间,290名受试者(25.8%)出现了CAC进展。所有受试者根据AIP分为三组。基线时各组之间的心血管参数存在显著差异。随访时的CAC和CAC进展发生率随着AIP三分位数的升高而逐渐增加。在逻辑回归分析中,比较AIP最高三分位数与最低三分位数时,CAC进展的优势比为2.27(95%CI:1.61-3.19;趋势P<0.01)。然而,在调整多个危险因素后,这种关联减弱(趋势P=0.67)。
在无CVD的受试者中,AIP与CAC进展之间存在显著相关性。虽然AIP不是CAC进展的独立预测因子,但在评估当前以及未来的CVD风险时,应将AIP与其他传统危险因素一起考虑。