Wang Lixia, Hui Xinjie, Huang Rong, Xiao Yi
Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
Department of Pulmonary and Critical Care Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
Sleep Med. 2025 May;129:375-382. doi: 10.1016/j.sleep.2025.03.017. Epub 2025 Mar 20.
The atherogenic index of plasma (AIP) has been demonstrated as a predictor for cardiovascular disease (CVD) in various populations. However, there are quite limited studies on the association between AIP and incident CVD among adults with obstructive sleep apnea (OSA).
Data were obtained from the Sleep Heart Health Study, including 2578 participants with OSA and without pre-existing CVD. AIP was calculated as lg (triglycerides/high-density lipoprotein-cholesterol). Baseline AIP was stratified into quartiles (Q1-Q4). Multivariate logistic regression and restricted cubic spline analyses were performed to examine the relationship between AIP and CVD.
After a median follow-up of 11.67 years, 580 (22.50 %) OSA patients developed CVD, including 184 (7.10 %) with myocardial infarction (MI), and 400 (15.50 %) with coronary artery disease (CHD [including MI]), and 127 (4.90 %) with stroke. The multivariate logistic regression and restricted cubic spline analyses demonstrated a significant association between AIP and incidence of CVD, CHD, and MI, but not stroke. Compared with Q1 group, the fully adjusted odds ratios from Q2 group to Q4 group were: 1.33 (0.98, 1.80), 1.41 (1.03, 1.92), and 1.54 (1.12, 2.14) for CVD; 1.71 (1.04, 2.86), 1.92 (1.17, 3.21), and 2.01 (1.19, 3.45) for MI; 1.48 (1.04, 2.11), 1.68 (1.18, 2.40), and 1.70 (1.18, 2.47) for CHD.
This study demonstrated that higher AIP level is associated with incident CVD, except stroke, independent of OSA severity and hypoxia among OSA patients. These findings suggest that monitoring AIP can facilitate the early identification of OSA patients at high risk of CVD.
血浆致动脉粥样硬化指数（AIP）已被证明是不同人群心血管疾病（CVD）的预测指标。然而，关于阻塞性睡眠呼吸暂停（OSA）成年患者中AIP与新发CVD之间关联的研究相当有限。
数据来自睡眠心脏健康研究，包括2578名患有OSA且无既往CVD的参与者。AIP计算为lg（甘油三酯/高密度脂蛋白胆固醇）。将基线AIP分层为四分位数（Q1-Q4）。进行多因素逻辑回归和受限立方样条分析以检验AIP与CVD之间的关系。
在中位随访11.67年后，580名（22.50%）OSA患者发生了CVD，其中184名（7.10%）发生心肌梗死（MI），400名（15.50%）发生冠状动脉疾病（CHD[包括MI]），127名（4.90%）发生中风。多因素逻辑回归和受限立方样条分析表明AIP与CVD、CHD和MI的发病率之间存在显著关联，但与中风无关。与Q1组相比，Q2组至Q4组经充分调整后的比值比分别为：CVD为1.33（0.98，1.80）、1.41（1.03，1.92）和1.54（1.12，2.14）；MI为1.7（1.04，2.86）、1.92（1.17，3.21）和2.01（1.19，3.45）；CHD为1.48（1.04，2.11）、1.68（1.18，2.40）和1.70（1.18，2.47）。
本研究表明，较高的AIP水平与新发CVD相关，但与中风无关，且独立于OSA患者的严重程度和缺氧情况。这些发现提示监测AIP有助于早期识别CVD高危的OSA患者。
