Zhao YanChen, Zhao XiaoYu, Li YunFei, Liu YueRuiJing, Wang JinQi, Wang JiaHe, Wu ZhiYuan, Liu Jia, Guo XiuHua, Tao LiXin
Department of Epidemiology and Health Statistics, Beijing Key Laboratory of Environment and Aging, School of Public Health, Capital Medical University, Beijing, China.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
JACC Adv. 2025 Aug 12;4(9):102062. doi: 10.1016/j.jacadv.2025.102062.
Atherogenic index of plasma (AIP) is recognized as a marker for atherosclerosis, but the impact of long-term AIP exposure on carotid plaque remains unknown.
The objective of the study is to assess the associations of cumulative AIP (cumAIP), incorporating the time course of cumAIP accumulation with the risk of carotid plaque.
A total of 9,202 participants from the Beijing Health Management Cohort were followed up until December 31, 2021. AIP was calculated as the logarithm of the ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C). CumAIP was derived by averaging AIP values between consecutive visits and multiplying by time intervals. HRs and 95% CIs were calculated using an adjusted Cox proportional hazards model to examine the association between AIP and carotid plaque. Discordance analysis of cumAIP vs TG and HDL-C was performed using the median as the cutoff. External validation was conducted using data from the Atherosclerosis Risk in Communities study.
During a median follow-up of 3.99 years, 2,879 participants developed carotid plaque. The highest quartile of cumAIP was significantly associated with an increased risk of carotid plaque (HR: 1.55; 95% CI: 1.36-1.76). Both low TG/high cumAIP group (HR: 1.26; 95% CI: 1.10-1.45) and high HDL-C/high cumAIP group (HR: 1.23; 95% CI: 1.09-1.39) also showed an elevated risk for carotid plaque.
CumAIP independently increased the risk of carotid plaque. Discordantly high cumAIP, rather than TG or HDL-C alone, poses a greater risk. Maintaining healthy AIP levels over time may be crucial for preventing atherosclerotic disease.
血浆致动脉粥样硬化指数（AIP）被认为是动脉粥样硬化的一个标志物，但长期暴露于AIP对颈动脉斑块的影响仍不清楚。
本研究的目的是评估累积AIP（cumAIP），结合cumAIP积累的时间过程与颈动脉斑块风险之间的关联。
对来自北京健康管理队列的9202名参与者进行随访，直至2021年12月31日。AIP计算为甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-C）比值的对数。CumAIP通过对连续两次就诊之间的AIP值进行平均并乘以时间间隔得出。使用调整后的Cox比例风险模型计算风险比（HRs）和95%置信区间（CIs），以检验AIP与颈动脉斑块之间的关联。使用中位数作为切点对cumAIP与TG和HDL-C进行不一致性分析。使用社区动脉粥样硬化风险研究的数据进行外部验证。
在中位随访3.99年期间，2879名参与者出现了颈动脉斑块。cumAIP的最高四分位数与颈动脉斑块风险增加显著相关（HR：1.55；95%CI：1.36 - 1.76）。低TG/高cumAIP组（HR：1.26；95%CI：1.10 - 1.45）和高HDL-C/高cumAIP组（HR：1.23；95%CI：1.09 - 1.39）也显示出颈动脉斑块风险升高。
CumAIP独立增加颈动脉斑块风险。cumAIP异常高，而非单独的TG或HDL-C，带来更大风险。长期维持健康的AIP水平可能对预防动脉粥样硬化疾病至关重要。
