Zhang Xin, Xie Pinliang, Yin Yong, Li Xinfeng
Department of Orthopedics, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China.
Front Endocrinol (Lausanne). 2025 May 28;16:1540558. doi: 10.3389/fendo.2025.1540558. eCollection 2025.
The atherogenic index of plasma (AIP), recognized as a marker of atherosclerosis, which also has a profound impact on bone metabolism. However, research exploring the association between the AIP and the probability of vertebral fractures in populations is still relatively scarce. The study aims to evaluate the association between the AIP and vertebral fractures probability in individuals in a longitudinal study.
A total of 1395 subjects who were older than 55 years and underwent CT scans for lung cancer screening between July 2019 and July 2021 were enrolled and followed up for a duration ranging from 8 months to 6 years. Among them, 91 individuals experienced new vertebral fractures. Participants were stratified into four groups based on AIP quartiles. The association between the AIP and vertebral fractures probability was then assessed by cox proportional hazards model.
The incidence of vertebral fracture decreased with increasing AIP (p for trend = 0.001). Kaplan-Meier survival analysis indicated that vertebral fractures were more likely to occur in patients with low levels of AIP (log-rank, all P < 0.05). Multivariate Cox regression analysis showed that AIP was negatively associated with the probability of vertebral fractures even after accounting for confounding factors (adjusted hazard ratio (aHR) = 0.27, 95%CI = 0.10-0.71 for continuous AIP; aHR = 0.48, 95%CI = 0.26-0.90 for Q2; aHR = 0.41, 95%CI = 0.19-0.88 for Q4, respectively). Subgroup analysis showed that such associations were mainly observed in male subjects. Restricted cubic splines further showed that the probability of vertebral fracture decreased with the increasing of AIP after adjusting with confounders in overall population and men, but not in women.
Our study demonstrated a strong association between the AIP and the probability of vertebral fracture. Low AIP may be an associated factor of vertebral fracture.
血浆致动脉粥样硬化指数（AIP）被认为是动脉粥样硬化的标志物，对骨代谢也有深远影响。然而，探索AIP与人群椎体骨折概率之间关联的研究仍然相对较少。本研究旨在通过纵向研究评估AIP与个体椎体骨折概率之间的关联。
纳入2019年7月至2021年7月期间年龄大于55岁且接受过肺癌筛查CT扫描的1395名受试者，随访时间为8个月至6年。其中，91人发生了新的椎体骨折。参与者根据AIP四分位数分为四组。然后通过Cox比例风险模型评估AIP与椎体骨折概率之间的关联。
椎体骨折的发生率随AIP升高而降低（趋势p值 = 0.001）。Kaplan-Meier生存分析表明，AIP水平低的患者更易发生椎体骨折（对数秩检验，所有P < 0.05）。多因素Cox回归分析显示，即使在考虑混杂因素后，AIP与椎体骨折概率仍呈负相关（连续AIP的调整风险比（aHR）= 0.27，95%置信区间（CI）= 0.10 - 0.71；Q2的aHR = 0.48，95%CI = 0.26 - 0.90；Q4的aHR = 0.41，95%CI = 0.19 - 0.88）。亚组分析表明，这种关联主要在男性受试者中观察到。限制立方样条进一步显示，在总体人群和男性中调整混杂因素后，椎体骨折概率随AIP升高而降低，但在女性中并非如此。
我们的研究表明AIP与椎体骨折概率之间存在密切关联。低AIP可能是椎体骨折的相关因素。
