Soheilifard Shirin, Faramarzi Elnaz, Mahdavi Reza
Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
Liver and Gastrointestinal Diseases Research Centre of Tabriz, University of Medical Sciences, P.O. Box: 1567812907, Tabriz, Iran.
J Health Popul Nutr. 2025 Feb 7;44(1):28. doi: 10.1186/s41043-025-00761-1.
Cardiovascular diseases are a leading cause of global mortality, with diet playing a key role in their progression. The Atherogenic Index of Plasma (AIP) is a predictive marker for cardiovascular risk, but its association with dietary intake across cardiometabolic phenotypes remains underexplored. This study investigates the relationship between dietary intake and AIP, hypothesizing that energy intake and macronutrients influence AIP and, consequently, cardiovascular risk.
This cross-sectional study analyzed data from 9,515 participants aged 35-55 in the Azar cohort study. Based on Body Mass Index (BMI) and metabolic syndrome (MetS), participants were classified into four phenotypes: metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUHNW), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUHO). Dietary intake was evaluated using a semi-quantitative food frequency questionnaire (FFQ), and AIP was calculated. Adjustments were made for age, gender, socioeconomic status, and physical activity.
A notable difference was observed in demographic and clinical status between cardiometabolic groups of males and females. The AIP was highest in the MUHNW (0.42 for males; 0.28 for females) and lowest in the MHNW (0.05 for males; -0.05 for females, P < 0.001). There was a statistically significant difference in the mean energy intake and the percentage of energy intake from protein among the cardiometabolic phenotypes (p < 0.001). After adjusting for confounders, only weak but meaningful correlations remained for energy, carbohydrate, and protein intake in the MUHO (r = 0.048, P = 0.01; r = 0.057, P = 0.003; and r = 0.050, P = 0.01) and for carbohydrate and lipid intake in the MHO (r = 0.034, P < 0.01 and r = -0.055, P < 0.001).
The study found weak but meaningful correlations between energy, carbohydrate, and protein intake and AIP in the MUHO phenotype and between carbohydrate and lipid intake and AIP in the MHO phenotype. This highlights the role of energy and carbohydrates in AIP within specific subgroups. Future research should focus on the effects of macronutrient combinations on AIP and long-term dietary impacts on metabolic health instead of BMI.
心血管疾病是全球死亡的主要原因，饮食在其发展过程中起着关键作用。血浆致动脉粥样硬化指数（AIP）是心血管风险的预测指标，但其与不同心脏代谢表型的饮食摄入之间的关联仍未得到充分研究。本研究调查饮食摄入与AIP之间的关系，假设能量摄入和宏量营养素会影响AIP，进而影响心血管风险。
这项横断面研究分析了阿扎尔队列研究中9515名年龄在35 - 55岁参与者的数据。根据体重指数（BMI）和代谢综合征（MetS），参与者被分为四种表型：代谢健康正常体重（MHNW）、代谢不健康正常体重（MUHNW）、代谢健康肥胖（MHO）和代谢不健康肥胖（MUHO）。使用半定量食物频率问卷（FFQ）评估饮食摄入，并计算AIP。对年龄、性别、社会经济地位和身体活动进行了调整。
观察到男性和女性心脏代谢组在人口统计学和临床状况上存在显著差异。AIP在MUHNW中最高（男性为0.42；女性为0.28），在MHNW中最低（男性为0.05；女性为 - 0.05，P < 0.001）。心脏代谢表型之间的平均能量摄入以及蛋白质能量摄入百分比存在统计学显著差异（p < 0.001）。在调整混杂因素后，仅在MUHO中能量、碳水化合物和蛋白质摄入以及在MHO中碳水化合物和脂质摄入存在微弱但有意义的相关性（r = 0.048，P = 0.01；r = 0.057，P = 0.003；r = 0.050，P = 0.01；r = 0.034，P < 0.01和r = - 0.055，P < 0.001）。
该研究发现，在MUHO表型中能量、碳水化合物和蛋白质摄入与AIP之间以及在MHO表型中碳水化合物和脂质摄入与AIP之间存在微弱但有意义的相关性。这突出了能量和碳水化合物在特定亚组AIP中的作用。未来的研究应关注宏量营养素组合对AIP的影响以及长期饮食对代谢健康而非BMI的影响。
