Department of Medical Imaging, People's Hospital of Zhengzhou University, #7 Wei Wu Road, Zhengzhou, 450003, Henan, China.
Department of Bariatric Metabolic Surgery, Central Hospital of Zhengzhou University, #195 Tongbai Road, Zhengzhou, 450003, Henan, China.
Cardiovasc Diabetol. 2024 Jun 29;23(1):226. doi: 10.1186/s12933-024-02330-y.
BACKGROUND: The atherogenic index of plasma (AIP) is closely associated with the onset of diabetes, with obesity being a significant risk factor for type 2 diabetes mellitus (T2DM). However, the association between the AIP and T2DM in overweight and obese populations has been infrequently studied. Therefore, this study aimed to explore this association in overweight and obese individuals with T2DM. METHODS: This cross-sectional analysis utilized data from 40,633 participants with a body mass index (BMI) ≥ 24 kg/m who were screened from January 2018 to December 2023 at Henan Provincial People's Hospital. Participants were categorized into groups of overweight and obese individuals with and without diabetes according to the T2DM criteria. The AIP, our dependent variable, was calculated using the formula log10 [(TG mol/L)/HDL-C (mol/L)]. We investigated the association between the AIP and T2DM in overweight and obese individuals using multivariate logistic regression, subgroup analysis, generalized additive models, smoothed curve fitting, and threshold effect analysis. Additionally, mediation analysis evaluated the role of inflammatory cells in AIP-related T2DM. RESULTS: Overweight and obese patients with T2DM exhibited higher AIP levels than those without diabetes. After adjusting for confounders, our results indicated a significant association between the AIP and the risk of T2DM in overweight and obese individuals (odds ratio (OR) = 5.17, 95% confidence interval (CI) 4.69-5.69). Notably, participants with a high baseline AIP (Q4 group) had a significantly greater risk of T2DM than those in the Q1 group, with an OR of 3.18 (95% CI 2.94-3.45). Subgroup analysis revealed that the association between the AIP and T2DM decreased with increasing age (interaction P < 0.001). In overweight and obese populations, the association between AIP and T2DM risk displayed a J-shaped nonlinear pattern, with AIP > - 0.07 indicating a significant increase in T2DM risk. Various inflammatory cells, including neutrophils, leukocytes, and monocytes, mediated 4.66%, 4.16%, and 1.93% of the associations, respectively. CONCLUSION: In overweight and obese individuals, the AIP was independently associated with T2DM, exhibiting a nonlinear association. Additionally, the association between the AIP and T2DM decreased with advancing age. Multiple types of inflammatory cells mediate this association.
背景：血浆致动脉粥样硬化指数（AIP）与糖尿病的发生密切相关，肥胖是 2 型糖尿病（T2DM）的重要危险因素。然而，超重和肥胖人群中 AIP 与 T2DM 的关系研究较少。因此，本研究旨在探讨超重和肥胖 T2DM 患者中 AIP 与 T2DM 的关系。
方法：本横断面分析利用了 2018 年 1 月至 2023 年 12 月在河南省人民医院筛查的 BMI≥24kg/m2 的 40633 名参与者的数据。根据 T2DM 标准，将参与者分为超重和肥胖且有或无糖尿病的组。使用公式 log10[(TG mol/L)/HDL-C(mol/L)]计算 AIP，作为我们的因变量。使用多变量逻辑回归、亚组分析、广义加性模型、平滑曲线拟合和阈值效应分析来研究超重和肥胖个体中 AIP 与 T2DM 之间的关系。此外，中介分析评估了炎症细胞在 AIP 相关 T2DM 中的作用。
结果：超重和肥胖 T2DM 患者的 AIP 水平高于无糖尿病患者。调整混杂因素后，结果表明 AIP 与超重和肥胖个体 T2DM 风险之间存在显著关联（比值比[OR] = 5.17，95%置信区间[CI] 4.69-5.69）。值得注意的是，基线 AIP 较高（Q4 组）的参与者发生 T2DM 的风险显著高于 Q1 组，OR 为 3.18（95%CI 2.94-3.45）。亚组分析显示，AIP 与 T2DM 之间的关联随年龄的增加而降低（交互 P<0.001）。在超重和肥胖人群中，AIP 与 T2DM 风险之间呈 J 形非线性关系，AIP>-0.07 时 T2DM 风险显著增加。中性粒细胞、白细胞和单核细胞等各种炎症细胞分别介导了 4.66%、4.16%和 1.93%的关联。
结论：在超重和肥胖个体中，AIP 与 T2DM 独立相关，呈非线性相关。此外，AIP 与 T2DM 之间的关联随年龄的增加而降低。多种类型的炎症细胞介导了这种关联。
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