血浆致动脉粥样硬化指数与心脏代谢表型之间的关联：来自阿扎尔队列人群的横断面研究

Association between cardiometabolic phenotypes with atherogenic index of plasma: a cross-sectional study from the Azar cohort population.

作者信息

Soheilifard Shirin, Faramarzi Elnaz, Mahdavi Reza

机构信息

Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.

Liver and Gastrointestinal Diseases Research Centre of Tabriz University of Medical Sciences, P.O. Box: 1567812907, Tabriz, Iran.

出版信息

BMC Cardiovasc Disord. 2025 Aug 22;25(1):627. doi: 10.1186/s12872-025-05043-6.

DOI:10.1186/s12872-025-05043-6

PMID:40847285

Abstract

BACKGROUND

Cardiometabolic phenotypes combine metabolic health and obesity measures for a more accurate cardiovascular risk assessment than body mass index (BMI) alone. The Atherogenic Index of Plasma (AIP), based on triglycerides and high-density lipoprotein cholesterol (HDL-C), is a promising cardiovascular disease (CVD) risk marker. This study explores the relationship between cardiometabolic phenotypes and AIP to improve understanding of their combined predictive value for CVD risk.

METHODS

This cross-sectional study analyzed data from 9,515 participants aged 35-55 in the Azar Cohort Study. Metabolic syndrome (MetS) was defined using ATP III criteria. Participants were classified into four phenotypes: metabolically healthy normal weight (MHNW, BMI < 25 kg/m), metabolically unhealthy normal weight (MUHNW, BMI < 25 kg/m), metabolically healthy obese (MHO, BMI ≥ 25 kg/m), and metabolically unhealthy obese (MUHO, BMI ≥ 25 kg/m). AIP was calculated as the logarithm of triglycerides to HDL. Multinomial regression was used to analyze the relationship between AIP tertiles and phenotypes using both unadjusted and adjusted models. Confounders were controlled for across the three groups.

RESULTS

Among participants, 50.4% were classified as MHO and 28.2% as MUHO. High-risk AIP levels (> 0.21) were found in 79.6% of MUHNW and 64.6% of MUHO, compared to 18.6% of MHO and 13.5% of MHNW. After adjusting for age, physical activity (METs), the wealth score index (WSI), and smoking status, the odds ratios (ORs) for cardiometabolic phenotypes in the high-risk AIP group remained significant. At the high-risk level, MUHNW (OR = 63.49, p < 0.001), MHO (OR = 1.96, p < 0.001), and MUHO (OR = 32.15, p < 0.001) showed significant associations.

CONCLUSION

In this study, significant associations were found between cardiometabolic phenotypes and AIP. Findings emphasize integrating metabolic health assessments with AIP to improve CVD risk identification. Prospective longitudinal studies are also needed to confirm these associations.

摘要

背景

心脏代谢表型结合了代谢健康和肥胖指标，用于进行比仅使用体重指数（BMI）更准确的心血管风险评估。基于甘油三酯和高密度脂蛋白胆固醇（HDL-C）的血浆致动脉粥样硬化指数（AIP）是一种很有前景的心血管疾病（CVD）风险标志物。本研究探讨心脏代谢表型与AIP之间的关系，以增进对它们联合预测CVD风险价值的理解。

方法

这项横断面研究分析了阿扎尔队列研究中9515名35至55岁参与者的数据。代谢综合征（MetS）采用ATP III标准进行定义。参与者被分为四种表型：代谢健康正常体重（MHNW，BMI＜25kg/m²）、代谢不健康正常体重（MUHNW，BMI＜25kg/m²）、代谢健康肥胖（MHO，BMI≥25kg/m²）和代谢不健康肥胖（MUHO，BMI≥25kg/m²）。AIP计算为甘油三酯与HDL的对数。使用未调整和调整模型的多项回归分析AIP三分位数与表型之间的关系。在三组中对混杂因素进行了控制。

结果

在参与者中，50.4%被分类为MHO，28.2%被分类为MUHO。在MUHNW的79.6%和MUHO的64.6%中发现高风险AIP水平（＞0.21），相比之下，MHO为18.6%，MHNW为13.5%。在调整年龄、身体活动（代谢当量）、财富评分指数（WSI）和吸烟状况后，高风险AIP组中心脏代谢表型的优势比（OR）仍然显著。在高风险水平下，MUHNW（OR = 63.49，p＜0.001）、MHO（OR = 1.96，p＜0.001）和MUHO（OR = 32.15，p＜0.001）显示出显著关联。