Jiangxi Cardiovascular Research Institute, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi Province, China.
Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi Province, China.
Cardiovasc Diabetol. 2024 Sep 30;23(1):355. doi: 10.1186/s12933-024-02449-y.
The impact of dynamic changes in the degree of atherosclerosis on the development of prediabetes remains unclear. This study aims to investigate the association between cumulative atherogenic index of plasma (CumAIP) exposure during follow-up and the development of prediabetes in middle-aged and elderly individuals.
A total of 2,939 prediabetic participants from the first wave of the China Health and Retirement Longitudinal Study (CHARLS) were included. The outcomes for these patients, including progression to diabetes and regression to normal fasting glucose (NFG), were determined using data from the third wave. CumAIP was calculated as the ratio of the average AIP values measured during the first and third waves to the total exposure duration. The association between CumAIP and the development of prediabetes was analyzed using multivariable Cox regression and restricted cubic spline (RCS) regression.
During a median follow-up period of 3 years, 15.21% of prediabetic patients progressed to diabetes, and 22.12% regressed to NFG. Among the groups categorized by CumAIP quartiles, the proportion of prediabetes progressing to diabetes gradually increased (Q1: 10.61%, Q2: 13.62%, Q3: 15.65%, Q4: 20.95%), while the proportion regressing to NFG gradually decreased (Q1: 23.54%, Q2: 23.71%, Q3: 22.18%, Q4: 19.05%). Multivariable-adjusted Cox regression showed a significant positive linear correlation between high CumAIP exposure and prediabetes progression, and a significant negative linear correlation with prediabetes regression. Furthermore, in a stratified analysis, it was found that compared to married individuals, those who were unmarried (including separated, divorced, widowed, or never married) had a relatively higher risk of CumAIP-related diabetes.
CumAIP is closely associated with the development of prediabetes. High CumAIP exposure not only increases the risk of prediabetes progression but also hinders its regression within a certain range. These findings suggest that monitoring and maintaining appropriate AIP levels may help prevent the deterioration of blood glucose levels.
动脉粥样硬化程度的动态变化对糖尿病前期发展的影响尚不清楚。本研究旨在探讨随访期间累积血浆致动脉粥样硬化指数（CumAIP）暴露与中年和老年人糖尿病前期发展之间的关系。
共纳入中国健康与养老追踪调查（CHARLS）第 1 波的 2939 例糖尿病前期患者。使用第 3 波的数据确定这些患者的结局，包括进展为糖尿病和恢复为正常空腹血糖（NFG）。CumAIP 计算为第 1 波和第 3 波平均 AIP 值与总暴露时间的比值。使用多变量 Cox 回归和限制性立方样条（RCS）回归分析 CumAIP 与糖尿病前期发展之间的关系。
中位随访 3 年期间，15.21%的糖尿病前期患者进展为糖尿病，22.12%恢复为 NFG。在按 CumAIP 四分位数分类的各组中，糖尿病前期进展为糖尿病的比例逐渐增加（Q1：10.61%，Q2：13.62%，Q3：15.65%，Q4：20.95%），而恢复为 NFG 的比例逐渐降低（Q1：23.54%，Q2：23.71%，Q3：22.18%，Q4：19.05%）。多变量调整的 Cox 回归显示，高 CumAIP 暴露与糖尿病前期进展呈显著正线性相关，与糖尿病前期恢复呈显著负线性相关。此外，在分层分析中，与已婚者相比，未婚者（包括分居、离婚、丧偶或未婚）CumAIP 相关糖尿病的风险相对较高。
CumAIP 与糖尿病前期的发展密切相关。高 CumAIP 暴露不仅增加了糖尿病前期进展的风险，而且在一定范围内还阻碍了其恢复。这些发现表明，监测和维持适当的 AIP 水平可能有助于防止血糖水平恶化。
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