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The Association Between Atherogenic Index of Plasma and Type 2 Diabetes Mellitus in a Multi-Ethnic Population of
Reza Amani-Beni1, Ghazal Ghasempour Dabaghi1,2, Noushin Mohammadifard1
1Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Higher atherogenic index of plasma (AIP) is linked to increased odds of type 2 diabetes mellitus (T2DM) and higher fasting blood sugar (FBS) in patients with premature coronary artery disease (PCAD). Findings suggest potential ethnic variations warranting further investigation.
Area of Science:
- Cardiology
- Endocrinology
- Metabolic Syndrome
Background:
- The atherogenic index of plasma (AIP) serves as a lipid-based marker for cardiometabolic risk.
- Understanding the association between AIP and cardiometabolic conditions like type 2 diabetes mellitus (T2DM) is crucial for risk assessment.
Purpose of the Study:
- To investigate the association between AIP and prevalent T2DM in patients with premature coronary artery disease (PCAD).
- To examine the relationship between AIP and fasting blood sugar (FBS) levels in the same patient cohort.
- To explore potential differences in these associations across various Iranian ethnic groups.
Main Methods:
- Analysis of 2143 patients with angiographically confirmed PCAD from the Iran Premature Coronary Artery Disease (IPAD) study.
- AIP calculated as log10 (triglycerides/high-density lipoprotein cholesterol).
- Multivariable logistic regression and generalized linear models used to assess associations between AIP, T2DM, and FBS.
Main Results:
- The highest quartile of AIP was associated with significantly higher odds of prevalent T2DM (OR: 1.57) compared to the lowest quartile.
- Each one-unit increase in AIP correlated with increased odds of T2DM (OR: 1.99).
- Higher AIP levels were significantly associated with elevated FBS (15.23 mg/dL higher in the highest quartile).
- Exploratory analyses indicated the association was most pronounced in the Fars subgroup, with imprecise estimates in smaller ethnic groups.
Conclusions:
- Elevated AIP is significantly associated with prevalent T2DM and higher FBS in patients with PCAD.
- Findings suggest potential ethnicity-related heterogeneity in the AIP-cardiometabolic risk association, requiring cautious interpretation.
- Further prospective studies are recommended to clarify the predictive and risk-stratification value of AIP in this population.
Background:
The atherogenic index of plasma (AIP) is a lipid-based indicator of cardiometabolic risk. We examined whether AIP is associated with prevalent type 2 diabetes mellitus (T2DM) and fasting blood sugar (FBS) in patients with premature coronary artery disease (PCAD) and explored whether this association differed across Iranian ethnic groups.
Methods:
We analysed 2143 patients with angiographically confirmed PCAD from the Iran Premature Coronary Artery Disease (IPAD) study, of whom 1945 had valid AIP data. CAD was defined as ≥ 50% stenosis in the left main artery or ≥ 75% stenosis in another major coronary vessel. AIP was calculated as log10 (triglycerides/high-density lipoprotein cholesterol). Multivariable logistic regression was used to assess the association between AIP and prevalent T2DM, and generalized linear models were used to assess the association between AIP and FBS.
Results:
In the fully adjusted model, including lipid-lowering medication use, participants in the highest AIP quartile had higher odds of prevalent T2DM than those in the lowest quartile (OR: 1.57; 95% CI: 1.14, 2.16; p = 0.005; P for trend = 0.002). Each 1-unit increase in AIP was associated with higher odds of prevalent T2DM (OR: 1.99; 95% CI: 1.26, 3.14; p = 0.003). Higher AIP was also associated with higher FBS; compared with the lowest quartile, the highest quartile had a 15.23 mg/dL higher FBS level in the fully adjusted model (95% CI: 7.61, 22.84; p < 0.001). In exploratory ethnicity-stratified analyses, the association was most evident in the Fars subgroup, while estimates in several smaller ethnic groups were imprecise.
Conclusions:
Higher AIP was associated with prevalent T2DM and higher FBS in patients with PCAD. Exploratory analyses suggested possible ethnicity-related heterogeneity, but these subgroup findings should be interpreted cautiously. Prospective studies are needed to determine whether AIP has predictive or clinical risk-stratification value in this population.
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