Association Between the Atherogenic Index of Plasma and Long-term Risk of Type 2 Diabetes: a 12-year Cohort Study Based on the Japanese Population

Overview

Journal Cardiovasc Diabetol

Publisher Biomed Central

Date 2025 Jan 30

PMID 39885511

Authors

Qianxing Zhou

Yamei Wu

Mingkang Li

Affiliations

Soon will be listed here.

Abstract

Background: Atherosclerotic dyslipidemia is associated with an increased risk of type 2 diabetes (T2D). Although previous studies have demonstrated an association between the atherogenic index of plasma (AIP) and insulin resistance, there remains a scarcity of large cohort studies investigating the association between AIP and the long-term risk of T2D in the general population. This study aims to investigate the potential association between AIP and the long-term risk of T2D in individuals with normal fasting plasma glucose levels.

Methods: This retrospective cohort study included 15,453 participants. The AIP was calculated using the formula log [triglyceride (mmol/L)/high-density lipoprotein cholesterol (mmol/L)]. Cox proportional hazard regression models were employed to assess the association between AIP and T2D risk. The nonlinear association was examined using a restricted cubic spline (RCS) model.

Results: During an average follow-up period of 6.05 years, 373 participants developed T2D. After adjusting for confounding factors, elevated AIP was independently associated with an increased risk of developing T2D (HR 1.763, 95%CI 1.210-2.568, P = 0.003). The RCS analysis revealed a J-shaped association between AIP and T2D risk, with a sharp increase in risk when AIP levels exceeded - 0.268. Moreover, time-dependent receiver operating characteristic analysis consistently demonstrated a moderate predictability of AIP for new-onset T2D within 1 to 12 years.

Conclusion: The AIP exhibits a J-shaped association with the risk of developing T2D. Therefore, maintaining AIP levels below a certain threshold (-0.268) might help prevent the onset of T2D.

References

Li Y, Kao T, Chang P, Chen W, Wu L . Atherogenic index of plasma as predictors for metabolic syndrome, hypertension and diabetes mellitus in Taiwan citizens: a 9-year longitudinal study. Sci Rep. 2021; 11(1):9900. PMC: 8110777. DOI: 10.1038/s41598-021-89307-z. View

Kanonidou C . Small dense low-density lipoprotein: Analytical review. Clin Chim Acta. 2021; 520:172-178. DOI: 10.1016/j.cca.2021.06.012. View

Dobiasova M, Frohlich J . The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem. 2001; 34(7):583-8. DOI: 10.1016/s0009-9120(01)00263-6. View

Shi Y, Wen M . Sex-specific differences in the effect of the atherogenic index of plasma on prediabetes and diabetes in the NHANES 2011-2018 population. Cardiovasc Diabetol. 2023; 22(1):19. PMC: 9887826. DOI: 10.1186/s12933-023-01740-8. View

You F, Gao J, Gao Y, Li Z, Shen D, Zhong W . Association between atherogenic index of plasma and all-cause mortality and specific-mortality: a nationwide population‑based cohort study. Cardiovasc Diabetol. 2024; 23(1):276. PMC: 11283706. DOI: 10.1186/s12933-024-02370-4. View

Lan Y, Chen G, Wu D, Ding X, Huang Z, Wang X . Temporal relationship between atherogenic dyslipidemia and inflammation and their joint cumulative effect on type 2 diabetes onset: a longitudinal cohort study. BMC Med. 2023; 21(1):31. PMC: 9870774. DOI: 10.1186/s12916-023-02729-6. View

Yang H, Kuang M, Yang R, Xie G, Sheng G, Zou Y . Evaluation of the role of atherogenic index of plasma in the reversion from Prediabetes to normoglycemia or progression to Diabetes: a multi-center retrospective cohort study. Cardiovasc Diabetol. 2024; 23(1):17. PMC: 10771677. DOI: 10.1186/s12933-023-02108-8. View

Hirano T . Pathophysiology of Diabetic Dyslipidemia. J Atheroscler Thromb. 2018; 25(9):771-782. PMC: 6143775. DOI: 10.5551/jat.RV17023. View

Goodpaster B, Kelley D . Skeletal muscle triglyceride: marker or mediator of obesity-induced insulin resistance in type 2 diabetes mellitus?. Curr Diab Rep. 2003; 2(3):216-22. DOI: 10.1007/s11892-002-0086-2. View

10.

Steiner G, Vranic M . Hyperinsulinemia and hypertriglyceridemia, a vicious cycle with atherogenic potential. Int J Obes. 1982; 6 Suppl 1:117-24. View

11.

Ma L, Sun F, Zhu K, Han Q, Sun Q . The Predictive Value of Atherogenic Index of Plasma, Non- High Density Lipoprotein Cholesterol (Non-HDL-C), Non-HDL-C/HDL-C, and Lipoprotein Combine Index for Stroke Incidence and Prognosis in Maintenance Hemodialysis Patients. Clin Interv Aging. 2024; 19:1235-1245. PMC: 11230120. DOI: 10.2147/CIA.S461150. View

12.

Weisberg S, McCann D, Desai M, Rosenbaum M, Leibel R, Ferrante Jr A . Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest. 2003; 112(12):1796-808. PMC: 296995. DOI: 10.1172/JCI19246. View

13.

Vaisar T, Pennathur S, Green P, Gharib S, Hoofnagle A, Cheung M . Shotgun proteomics implicates protease inhibition and complement activation in the antiinflammatory properties of HDL. J Clin Invest. 2007; 117(3):746-56. PMC: 1804352. DOI: 10.1172/JCI26206. View

14.

Igweokpala S, Sule N, Douros A, Yu O, Filion K . Incretin-based drugs and the risk of diabetic retinopathy among individuals with type 2 diabetes: A systematic review and meta-analysis of observational studies. Diabetes Obes Metab. 2023; 26(2):721-731. DOI: 10.1111/dom.15367. View

15.

Wan Q, Wang F, Guan Q, Liu Y, Wang C, Feng L . Regression to normoglycaemia by fenofibrate in pre-diabetic subjects complicated with hypertriglyceridaemia: a prospective randomized controlled trial. Diabet Med. 2010; 27(11):1312-7. DOI: 10.1111/j.1464-5491.2010.03107.x. View

16.

Saltiel A, Olefsky J . Inflammatory mechanisms linking obesity and metabolic disease. J Clin Invest. 2017; 127(1):1-4. PMC: 5199709. DOI: 10.1172/JCI92035. View

17.

Fritzen A, Domingo-Espin J, Lundsgaard A, Kleinert M, Israelsen I, Carl C . ApoA-1 improves glucose tolerance by increasing glucose uptake into heart and skeletal muscle independently of AMPKα. Mol Metab. 2020; 35:100949. PMC: 7082546. DOI: 10.1016/j.molmet.2020.01.013. View

18.

Zhu Y, Chen M, Liu K, Gao A, Kong X, Liu Y . Atherogenic Index of Plasma and the Risk of In-Stent Restenosis in Patients with Acute Coronary Syndrome beyond the Traditional Risk Factors. J Atheroscler Thromb. 2021; 29(8):1226-1235. PMC: 9371759. DOI: 10.5551/jat.63136. View

19.

Babaahmadi-Rezaei H, Raeisizadeh M, Zarezade V, Noemani K, Mashkournia A, Ghaderi-Zefrehi H . Comparison of atherogenic indices for predicting the risk of metabolic syndrome in Southwest Iran: results from the Hoveyzeh Cohort Study (HCS). Diabetol Metab Syndr. 2024; 16(1):112. PMC: 11112906. DOI: 10.1186/s13098-024-01349-1. View

20.

Zhu X, Deng F, Lei S . Meta-analysis of Atherogenic Index of Plasma and other lipid parameters in relation to risk of type 2 diabetes mellitus. Prim Care Diabetes. 2014; 9(1):60-7. DOI: 10.1016/j.pcd.2014.03.007. View