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The longitudinal effect of the atherogenic index of plasma on type 2 diabetes in middle-aged and older Chinese

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Abstract

Aims

Atherogenic Index of Plasma (AIP) has been proposed as a novel marker of plasma atherogenicity, but its longitudinal predictive value in type 2 diabetes mellitus (T2DM) remains unclear. We aimed to assess the associations of AIP and its longitudinal transition with T2DM among middle-aged and older Chinese.

Methods

Data were extracted from four rounds of the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018). AIP was calculated as log10 (triglyceride/high-density lipoprotein cholesterol). Participants were classified into high and low AIP groups at baseline, and subsequently into four transition patterns during follow-up: maintained-high, maintained-low, high-to-low, and low-to-high AIP. Multivariable Cox frailty models were applied to explore the longitudinal transition patterns of AIP on the development of T2DM.

Results

A total of 8760 subjects without T2DM were selected in 2011, of which 981 developed T2DM until 2018. When compared with people with maintained-low AIP patterns, those with transition patterns of maintained-high AIP, high-to-low AIP, and low-to-high AIP were at around 1.5 times higher risk of T2DM (HRadj = 1.69, 1.32, and 1.47, respectively, all P < 0.05). However, the risk of T2DM did not decrease in the high-to-low AIP group as compared to the maintained-high AIP group.

Conclusions

Three longitudinal AIP transition patterns (maintained-high AIP, high-to-low AIP, and low-to-high AIP) were associated with the development of T2DM. Preventions are needed to combat T2DM at an early dyslipidemic stage.

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Availability of data and material

The data that support the findings of this study are available from [CHARLS Database] but restrictions apply to the availability of these data, which were used under license for the current study, and so are not publicly available. Data are, however, available from the authors upon reasonable request and with permission of [CHARLS].

Code availability

Some codes generated during the study are available from the corresponding author by request.

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Acknowledgements

All authors thank the China Health and Retirement Longitudinal Study (CHARLS) for providing data. We are grateful to those who designed, conducted, and participated in this study.

Funding

This study has received no funding.

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Authors and Affiliations

  1. School of Public Health and Women’s Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China

    Qian Yi, Ziyang Ren, Siyu Zhu, Shuting Li & Peige Song

  2. Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China

    Guannan Bai

  3. Medical School, University of Edinburgh, Edinburgh, UK

    Chunlu Li

  4. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China

    Hongjiang Wu

  5. Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, China

    Yimin Zhu

Authors
  1. Qian Yi
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  4. Siyu Zhu
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  9. Peige Song
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Contributions

PS and YZ designed the study. QY and ZR managed and analyzed the data. QY and GB prepared the first draft. SZ and SL reviewed and edited the manuscript, with comments from HW, PS, and YZ. All authors were involved in revising the paper and gave final approval of the submitted versions.

Corresponding authors

Correspondence to Yimin Zhu or Peige Song.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

Ethical approval for all the CHARLS waves was granted from the Institutional Review Board at Peking University. The IRB approval number for the main household survey, including anthropometrics, is IRB00001052-11015; the IRB approval number for biomarker collection was IRB00001052-11014.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Participants signed informed consent regarding publishing their data.

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This article belongs to the topical collection Eye Complications of Diabetes. Managed by Giuseppe Querques.

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Yi, Q., Ren, Z., Bai, G. et al. The longitudinal effect of the atherogenic index of plasma on type 2 diabetes in middle-aged and older Chinese. Acta Diabetol 59, 269–279 (2022). https://doi.org/10.1007/s00592-021-01801-y

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  • DOI: https://doi.org/10.1007/s00592-021-01801-y

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