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心血管-肾脏-代谢综合征0至3期人群血浆致动脉粥样硬化指数与中风风险的关联:来自中国健康与养老追踪调查的首个证据

Association of Atherogenic Index of Plasma With Stroke Risk in a Population With Cardiovascular-Kidney-Metabolic Syndrome Stages 0 to 3: The First Evidence From the China Health and Retirement Longitudinal Study.

作者信息

Liu Zhanao, Zhou Dayong, Tang Yao, Huo Guijun

机构信息

The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital Suzhou Jiangsu China.

出版信息

J Am Heart Assoc. 2025 Jul 15;14(14):e039983. doi: 10.1161/JAHA.124.039983. Epub 2025 Jul 14.

Abstract

BACKGROUND

The atherogenic index of plasma (AIP) is a marker of lipids and atherosclerosis. However, its associations with stroke risk in a population with cardiovascular-kidney-metabolic (CKM) syndrome stages 0 to 3 remain unclear.

METHODS

The data for this study were obtained from CHARLS (China Health and Retirement Longitudinal Study). The AIP was calculated using the formula: AIP=log10 (triglycerides/high-density lipoprotein cholesterol). The outcome of this study was stroke events. Cox regression models and restricted cubic spline were applied to investigate the relationship between AIP and stroke risk in populations with CKM syndrome stages 0 to 3.

RESULTS

A total of 7664 participants were included in this study, with a mean age of 59.30±9.58 years, and 53.08% were women. A total of 683 (8.91%) stroke events were recorded. After fully adjusting for covariates, each 1-unit increase in AIP was associated with a 22% increase in stroke risk (hazard ratio [HR], 1.22 [95% CI, 1.10-1.34]). AIP was further categorized into quartiles. The adjusted HRs for quartile 2, quartile 3, and quartile 4 compared with quartile 1 were 1.48 (95% CI, 1.18-1.86), 1.70 (95% CI, 1.36-2.14), and 1.58 (95% CI, 1.25-2.00), respectively. Results from restricted cubic spline revealed a significant nonlinear relationship within a population with CKM syndrome stages 0 to 3 between AIP and stroke risk (threshold=1.516).

CONCLUSIONS

This study found a nonlinear association between AIP and increased stroke incidence in a population with CKM syndrome stages 0 to 3, with a threshold of 1.516. These findings indicate that AIP could serve as a potential predictor for the risk of stroke.

摘要

背景

血浆致动脉粥样硬化指数(AIP)是脂质和动脉粥样硬化的一个标志物。然而,在心血管-肾脏-代谢(CKM)综合征0至3期人群中,其与中风风险的关联尚不清楚。

方法

本研究的数据来自中国健康与养老追踪调查(CHARLS)。AIP采用公式计算:AIP = log10(甘油三酯/高密度脂蛋白胆固醇)。本研究的结局是中风事件。采用Cox回归模型和限制性立方样条来研究CKM综合征0至3期人群中AIP与中风风险之间的关系。

结果

本研究共纳入7664名参与者,平均年龄为59.30±9.58岁,53.08%为女性。共记录了683例(8.91%)中风事件。在对协变量进行充分调整后,AIP每增加1个单位,中风风险增加22%(风险比[HR],1.22[95%置信区间,1.10 - 1.34])。AIP进一步分为四分位数。与第一四分位数相比,第二四分位数、第三四分位数和第四四分位数的调整后HR分别为1.48(95%置信区间,1.18 - 1.86)、1.70(95%置信区间,1.36 - 2.14)和1.58(95%置信区间,1.25 - 2.00)。限制性立方样条的结果显示,在CKM综合征0至3期人群中,AIP与中风风险之间存在显著的非线性关系(阈值 = 1.516)。

结论

本研究发现,在CKM综合征0至3期人群中,AIP与中风发病率增加之间存在非线性关联,阈值为1.516。这些发现表明,AIP可作为中风风险的潜在预测指标。

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