血浆致动脉粥样硬化指数与传统危险因素之外的心血管风险的关联：一项全国范围内基于人群的队列研究。
Association of the atherogenic index of plasma with cardiovascular risk beyond the traditional risk factors: a nationwide population-based cohort study.
机构信息
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon, Republic of Korea.
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
出版信息
Cardiovasc Diabetol. 2022 May 22;21(1):81. doi: 10.1186/s12933-022-01522-8.
BACKGROUND
The atherogenic index of plasma (AIP) is composed of triglycerides and high-density lipoprotein cholesterol and is a novel marker for assessing the risk of atherogenicity and cardiometabolic health. An association between AIP and greater frequency of major adverse cardiovascular events (MACEs) in patients with type 2 diabetes mellitus and high cardiovascular (CV) disease risk has been reported. However, only few studies have examined the correlation between AIP and CV risk in general populations. We thus aimed to evaluate the relationship between AIP and CV diseases using a large-scale population dataset from the Korean National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS).
METHODS
A total of 514,866 participants were enrolled from the NHIS-HEALS and classified according to the AIP quartiles. We performed univariate and multivariate Cox proportional hazards regression analyses to determine the association between AIP and MACEs, CV events, and CV mortality.
RESULTS
During follow-up, we documented 12,133, 11,055, and 1942 cases of MACEs, CV events, and CV mortality, respectively. The multivariate-adjusted hazard ratios [HRs; 95% confidence interval (CI)] for MACEs gradually and significantly increased with the AIP quartiles [1.113 (1.054-1.175) in Q2, 1.175 (1.113-1.240) in Q3, and 1.278 (1.209-1.350) in Q4], following an adjustment for the conventional CV risk factors, including age, sex, body mass index, smoking, alcohol drinking, physical activities, household income, fasting glucose, systolic blood pressure, low-density lipoprotein cholesterol, and estimated glomerular filtration rate. In subgroup analyses, the association of AIP with MACEs and CV events was particularly outstanding in patients with diabetes.
CONCLUSIONS
AIP was significantly associated with CV risks after adjusting for the traditional risk factors. Therefore, it may be used as an effective mass screening method to identify patients at a high risk of CV events.
背景
血浆致动脉粥样硬化指数（AIP）由甘油三酯和高密度脂蛋白胆固醇组成，是评估动脉粥样硬化性和心脏代谢健康风险的新型标志物。已有研究报道，在 2 型糖尿病和高心血管（CV）疾病风险患者中，AIP 与主要不良心血管事件（MACEs）发生频率较高之间存在关联。然而，仅有少数研究检查了 AIP 与普通人群 CV 风险之间的相关性。因此，我们旨在使用来自韩国国家健康保险服务-全国健康筛查队列（NHIS-HEALS）的大型人群数据集来评估 AIP 与 CV 疾病之间的关系。
方法
共纳入 514866 名来自 NHIS-HEALS 的参与者，并根据 AIP 四分位数进行分类。我们进行了单变量和多变量 Cox 比例风险回归分析，以确定 AIP 与 MACEs、CV 事件和 CV 死亡率之间的关联。
结果
在随访期间，我们分别记录了 12133、11055 和 1942 例 MACEs、CV 事件和 CV 死亡率。多变量调整后的风险比（HR；95%置信区间[CI]）随着 AIP 四分位数的升高而逐渐显著增加[Q2 为 1.113（1.054-1.175），Q3 为 1.175（1.113-1.240），Q4 为 1.278（1.209-1.350）]，同时调整了年龄、性别、体重指数、吸烟、饮酒、身体活动、家庭收入、空腹血糖、收缩压、低密度脂蛋白胆固醇和估算肾小球滤过率等传统 CV 危险因素。在亚组分析中，AIP 与 MACEs 和 CV 事件的关联在糖尿病患者中尤为显著。
结论
在调整传统危险因素后，AIP 与 CV 风险显著相关。因此，它可能被用作一种有效的大规模筛查方法，以识别 CV 事件风险较高的患者。
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