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Elevated atherogenic index of plasma associated with stroke risk in general Chinese

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Abstract

Background and aims

The atherogenic index of plasma (AIP) is supposed to be associated with cardiovascular disease (CVD), but there is limited evidence on its longitudinal effect. Our study aimed to explore the associations between baseline and long-term AIP with the risk of stroke and its subtypes.

Methods and results

A total of 97,959 participants free of stroke at baseline were included in the Kailuan study. The AIP was calculated as the logarithm of the ratio of triglyceride to high-density lipoprotein cholesterol. The updated mean AIP was calculated as the average of the AIP from baseline to the first occurrence of outcome or the end of follow-up. The outcome was the first occurrence of stroke, including ischemic stroke (IS) and intracerebral hemorrhage (ICH). We used univariable and multivariable Cox proportional hazard models to explore the association between AIP and the risk of stroke. During a median follow-up of 12.79 years, a total of 6307 participants developed stroke, including 5482 IS and 1024 ICH. Compared with the 1st quartile of baseline AIP, the multivariate-adjusted HR in the 4th quartile was 1.12 (95% CI, 1.03–1.22, p for trend <0.001) for stroke risk. Same results were found in IS, but no significant association was found for ICH. The associations between updated mean AIP and stroke and its subtypes showed similar results.

Conclusions

Elevated levels of both baseline and long-term updated mean AIP were associated with the risk of stroke and IS but not ICH in the general population.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Acknowledgements

We thank all study participants, their relatives, the members of the survey teams at the 11 regional hospitals of the Kailuan Medical Group; and the project development and management teams at the Beijing Tiantan Hospital and the Kailuan Group.

Funding

This work was supported by the National Key Research and Development Program of China (2022YFC3600600), Training Fund for Open Projects at Clinical Institutes and Departments of Capital Medical University (CCMU2022ZKYXZ009), Beijing Natural Science Foundation Haidian original innovation joint fund (L222123), Fund for Young Talents of Beijing Medical Management Center (QML20230505), and National Key Research and Development Program of China (2018YFC1312400 and 2018YFC1312402).

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Author notes

  1. These authors contributed equally: Yijun Zhang, Shuohua Chen

Authors and Affiliations

  1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Yijun Zhang, Xue Tian, Qin Xu, Xue Xia, Xiaoli Zhang, Jing Li & Anxin Wang

  2. China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China

    Yijun Zhang, Xue Tian, Qin Xu, Xue Xia, Xiaoli Zhang, Jing Li & Anxin Wang

  3. Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China

    Yijun Zhang, Xue Tian, Qin Xu, Xue Xia, Xiaoli Zhang, Jing Li & Anxin Wang

  4. Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China

    Yijun Zhang & Xue Tian

  5. Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China

    Yijun Zhang & Xue Tian

  6. Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China

    Shuohua Chen & Shouling Wu

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  1. Yijun Zhang
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Contributions

Y.Z. wrote the manuscript. Y.Z., S.W., X.T. and J.L. researched the data. Q.X., X.X., X.Z. and S.C. researched the data and contributed to the discussion. A.W. contributed to the discussion and reviewed the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Shouling Wu or Anxin Wang.

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Conflict of interest

The authors declare no competing interests.

Ethical approval

The Kailuan study was performed according to the guidelines of the Helsinki Declaration and was approved by the Ethics Committee of Kailuan Hospital (approval number: 2006e05) and Beijing Tiantan Hospital (approval number: 2010-014-01). Each participant provided their written informed consent before participating in the study.

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Zhang, Y., Chen, S., Tian, X. et al. Elevated atherogenic index of plasma associated with stroke risk in general Chinese. Endocrine (2024). https://doi.org/10.1007/s12020-023-03677-0

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