Wu Wen, Li Yiming, Zhang Yupei, Chen Xing, Zhang Chunzhen, Qu Xingguang, Zhang Zhaohui, Zhang Rong, Peng Zhiyong
Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan430071, Hubei, China.
Clinical Research Center of Hubei Critical Care Medicine, Wuhan, 430071, Hubei, China.
Lipids Health Dis. 2025 Mar 25;24(1):111. doi: 10.1186/s12944-025-02520-x.
The atherogenic index of plasma (AIP) can be used to reveal atherosclerosis. This study evaluated the AIP's efficacy in predicting the prognosis of acute kidney injury (AKI) and severity of acute pancreatitis (AP).
This retrospective cohort study recruited AP cases from the First College of Clinical Medical Science of China Three Gorges University between January 2019 and October 2023, including 1470 patients. AIP was computed using the formula: log10 [serum triglyceride (mmol/L)/serum high-density lipoprotein cholesterol (mmol/L)]. The AIP relationships with AKI occurrence and AP severity were validated using multivariable logistic regression models, subgroup and sensitivity analyses, and curve fitting.
Among the 1470 patients with AP, 250 (17%) developed AKI and 166 (11.3%) with severe AP. AIP was positively correlated with AKI and the severity of AP. Potential confounders were adjusted, consequently, AIP was positively linearly related to AKI (P for non-linearity: 0.731, OR 2.5, 95% CI 1.31-4.77,) and the severity of AP (P for non-linearity: 0.145, OR 3.1, 95% CI 1.53-6.27), respectively. The strength of the association between AIP and AKI, along with the severity of AP, was demonstrated through stratified analyses. Significant interactions were not observed in sex, age, hypertension, BMI, diabetes mellitus, SOFA score, BISAP score, and etiology of AP (all P for interaction > 0.05). The areas under the curves for AIP in predicting the incidence of AKI and severity of AP were 0.64 and 0.65, respectively.
This is the first study to suggest that the AIP is critical for the assessment of AKI risk, recommending early screening of severity among AP cases. Due to the observational nature of the study, the potential for residual confounding, and the need for external validation in larger, independent cohorts.
血浆致动脉粥样硬化指数（AIP）可用于揭示动脉粥样硬化。本研究评估了AIP在预测急性肾损伤（AKI）预后和急性胰腺炎（AP）严重程度方面的效能。
这项回顾性队列研究纳入了2019年1月至2023年10月期间三峡大学第一临床医学院的AP病例，共1470例患者。AIP采用公式计算：log10[血清甘油三酯（mmol/L）/血清高密度脂蛋白胆固醇（mmol/L）]。使用多变量逻辑回归模型、亚组分析和敏感性分析以及曲线拟合来验证AIP与AKI发生及AP严重程度之间的关系。
在1470例AP患者中，250例（17%）发生了AKI，166例（11.3%）为重度AP。AIP与AKI及AP严重程度呈正相关。对潜在混杂因素进行调整后，AIP分别与AKI（非线性检验P值：0.731，OR 2.5，95%CI 1.31 - 4.77）和AP严重程度（非线性检验P值：0.145，OR 3.1，95%CI 1.53 - 6.27）呈正线性相关。通过分层分析证实了AIP与AKI及AP严重程度之间关联的强度。在性别、年龄、高血压、体重指数、糖尿病、序贯器官衰竭评估（SOFA）评分、床边急性胰腺炎严重程度评分（BISAP）以及AP病因方面均未观察到显著的交互作用（所有交互作用P值均>0.05）。AIP预测AKI发生率和AP严重程度的曲线下面积分别为0.64和0.65。
这是第一项表明AIP对评估AKI风险至关重要的研究，建议对AP病例进行早期严重程度筛查。由于本研究的观察性性质、存在残余混杂的可能性以及需要在更大的独立队列中进行外部验证。
