Qiu Peng, Guo Hongbin, Zhu Chao, Liu Yijun, Zheng Jiazhen, Pu Hongji, Lu Xinwu, Huang Qun, Liu Guang, Ye Kaichuang, Zhou Zhen
Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, 639 Zhizaoju Rd, Shanghai, 200011, China.
Department of Neuroscience, School of Translational Medicine, Monash University, 99 Commercial Rd, Melbourne, VIC, 3004, Australia.
Eur J Med Res. 2025 May 5;30(1):363. doi: 10.1186/s40001-025-02586-4.
Atherosclerosis of aortic wall has been suggested as a key pathological feature of abdominal aortic aneurysm (AAA). We conducted a first-ever prospective cohort study aiming at assessing the sex-specific association between atherogenic index of plasma (AIP) and risk of newly diagnosed AAA.
This study included 193,013 male and 226,785 female participants from the UK Biobank. AIP was calculated as a ratio of logarithmically transformed triglycerides to high-density lipoprotein-cholesterol. The outcome of interest was new AAA, identified by ICD-10 and OPCS-4 code, or by AAA-related death. All analyses were sex-stratified: Multivariable Cox proportional-hazard models were employed to assess the association between baseline AIP and AAA risk. Harrell's c index was estimated to assess the value of AIP added to the discrimination of AAA prediction model.
Over an average follow-up of 15.3 years, 1931 (1.00%) new AAA cases were recorded in males and 424 (0.19%) in females. In the fully adjusted models, compared with the bottom AIP quintile, HRs (95% CI) of newly diagnosed AAA was 1.67 (1.41, 1.96) in males and 1.75 (1.22, 2.52) in females within the top quintile. Subgroup analysis found smoking status significantly modified the association in females, with association existing only in female ever-smokers. Adding AIP into prediction model comprising age, smoking, and CVD history significantly improved the discrimination in males and male high-risk subgroups and in female ever-smokers (p < 0.05).
This study highlights the potential of AIP as a biomarker for AAA and its utility in identifying high-risk individuals qualified for AAA screening.
主动脉壁动脉粥样硬化被认为是腹主动脉瘤（AAA）的关键病理特征。我们开展了一项有史以来的前瞻性队列研究，旨在评估血浆致动脉粥样硬化指数（AIP）与新诊断AAA风险之间的性别特异性关联。
本研究纳入了英国生物银行的193,013名男性和226,785名女性参与者。AIP计算为对数转换后的甘油三酯与高密度脂蛋白胆固醇的比值。感兴趣的结局是通过ICD - 10和OPCS - 4编码或AAA相关死亡确定的新发AAA。所有分析均按性别分层：采用多变量Cox比例风险模型评估基线AIP与AAA风险之间的关联。估计Harrell's c指数以评估AIP对AAA预测模型判别能力的增加值。
在平均15.3年的随访期间，男性记录到1931例（1.00%）新发AAA病例，女性记录到424例（0.19%）。在完全调整模型中，与最低AIP五分位数相比，最高五分位数内男性新诊断AAA的HR（95%CI）为1.67（1.41, 1.96），女性为1.75（1.22, 2.52）。亚组分析发现吸烟状态显著改变了女性的关联，仅在曾经吸烟的女性中存在关联。将AIP纳入包含年龄、吸烟和心血管疾病史的预测模型中，显著改善了男性和男性高危亚组以及曾经吸烟女性的判别能力（p < 0.05）。
本研究强调了AIP作为AAA生物标志物的潜力及其在识别适合AAA筛查的高危个体中的作用。
