Yan Shaohua, Chai Ke, Yang Jiefu, Wang Hua
Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, 1 DaHua Road, Beijing, 100730, China.
Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, People's Republic of China.
Lipids Health Dis. 2025 Mar 6;24(1):84. doi: 10.1186/s12944-025-02504-x.
Frailty is a multifactorial syndrome associated with adverse health outcomes. The metabolic underpinnings of frailty, particularly lipid metabolism, are not fully understood. Unlike isolated lipid fractions or inflammatory markers, atherogenic index of plasma (AIP) integrates atherogenic lipid profiles and systemic inflammation. However, its association with frailty has not been extensively studied.
Six thousand four hundred participants from the National Health and Nutrition Examination Survey (NHANES) were enrolled. Frailty was calculated with the frailty index (FI), with scores ≥ 0.21 indicating frailty. Logistic regression adjusted for demographic, socioeconomic, and lifestyle factors evaluated the association between AIP and frailty. Restricted cubic splines (RCS) explored nonlinear associations, and subgroup analyses assessed interactions across age, sex, race, poverty income ratio, smoking status, drinking status, and marital status.
This study demonstrated a strong dose-response relationship between AIP and frailty. After full adjustment, Individuals in quartile 3 and 4 showed higher odds of frailty than those in lowest quartile, with ORs (95% CI) of 1.26(1.01,1.57) and 1.73(1.34,2.23), respectively. Continuous AIP measures also exhibited significant associations (OR: 1.82, 95% CI: 1.34-2.47). RCS analysis showed that AIP exhibited a nonlinear association with the risk of frailty. Subgroup analyses showed the associations were more pronounced in the females. The sensitivity analyses substantiated the stability and strength of the results.
Our findings suggest that elevated AIP levels are independently associated with frailty risk, particularly in females, highlighting its potential as a cost-effective biomarker for risk stratification. Future longitudinal studies are needed to validate AIP's predictive utility and uncover the underlying mechanisms.
衰弱是一种与不良健康结局相关的多因素综合征。衰弱的代谢基础，尤其是脂质代谢，尚未完全明确。与单一的脂质组分或炎症标志物不同，血浆致动脉粥样硬化指数（AIP）综合了致动脉粥样硬化的脂质谱和全身炎症。然而，其与衰弱的关联尚未得到广泛研究。
纳入了来自美国国家健康与营养检查调查（NHANES）的6400名参与者。使用衰弱指数（FI）计算衰弱情况，得分≥0.21表明存在衰弱。对人口统计学、社会经济和生活方式因素进行调整后的逻辑回归分析评估了AIP与衰弱之间的关联。受限立方样条（RCS）分析探讨非线性关联，亚组分析评估了年龄、性别、种族、贫困收入比、吸烟状况、饮酒状况和婚姻状况之间的相互作用。
本研究表明AIP与衰弱之间存在强烈的剂量反应关系。经过全面调整后，第三和第四四分位数的个体比最低四分位数的个体出现衰弱的几率更高，其比值比（95%置信区间）分别为1.26（1.01，1.57）和1.73（1.34，2.23）。连续的AIP测量值也显示出显著关联（比值比：1.82，95%置信区间：1.34 - 2.47）。RCS分析表明AIP与衰弱风险呈非线性关联。亚组分析显示这种关联在女性中更为明显。敏感性分析证实了结果的稳定性和强度。
我们的研究结果表明，AIP水平升高与衰弱风险独立相关，尤其是在女性中，凸显了其作为一种具有成本效益的风险分层生物标志物的潜力。未来需要进行纵向研究以验证AIP的预测效用并揭示潜在机制。
