Atherogenic dyslipidemia as a novel cardiovascular risk stratification tool in chronic obstructive pulmonary disease:...

Chronic obstructive pulmonary disease (COPD) is characterized by progressive airway obstruction and systemic inflammation, frequently accompanied by metabolic comorbidities, including dyslipidemia. The Atherogenic Index of Plasma (AIP), calculated as log10[triglycerides/high-density lipoprotein (HDL)-cholesterol], is strongly associated with atherosclerotic cardiovascular disease risk, yet its relationship with COPD-associated dyslipidemia remains underexplored. This study investigates the association between atherogenic dyslipidemia profiles and COPD duration, utilizing AIP as an evaluation metric. A hospital-based cross-sectional analytical study was conducted among 100 COPD patients without acute exacerbations. Fasting serum lipid profiles were analyzed using standardized protocols, and AIP was calculated for each participant. Patients were stratified into three AIP risk categories: low risk (AIP<0.21), moderate risk (AIP 0.21-0.5), and high risk (AIP>0.5). Associations between COPD duration, smoking status, demographic variables, and lipid parameters were examined using chi-square analysis. 60% of COPD patients demonstrated high atherogenic index profiles (AIP>0.5), indicating substantial cardiovascular risk. A significant positive correlation was found between COPD duration and AIP (r=0.456, p<0.001), as well as with triglycerides (r=0.341, p<0.001) and low-density lipoprotein-cholesterol (r=0.405, p<0.001). Conversely, COPD duration demonstrated a nonsignificant trend toward an inverse correlation with HDL-cholesterol (r=-0.173, p=0.089). Seventy-one percent of patients demonstrated low HDL-cholesterol (<40 mg/dL). Smoking status was significantly associated with elevated very low-density lipoprotein-cholesterol (p=0.002). The high prevalence of atherogenic dyslipidemia in COPD patients, as quantified by AIP, suggests that lipid profile alteration is progressive and correlates with disease duration. AIP represents a clinically relevant, cost-effective screening tool for identifying COPD patients at elevated cardiovascular risk, facilitating early intervention and personalized risk stratification strategies.