Atherogenic index of plasma is positively associated with the risk of all-cause death in elderly women
- 154 Downloads
The blood concentrations of total cholesterol and low-density lipoprotein (LDL) do not predict survival in patients older than 60 years. The atherogenic index of plasma (AIP) is a logarithm of the triacylglycerol to high-density lipoprotein (HDL) ratio and a surrogate for the concentration of small dense LDL. It might be a better reflection of the risk of all-cause death in elderly patients.
We conducted a prospective observational study of patients with arterial hypertension older than 60 years. The concentrations of total cholesterol, LDL, HDL and triacylglycerol were measured at the time of the recruitment and the patients were observed for 10 years. Cox regression analysis was performed to assess the effects of lipoproteins and AIP on survival.
A total of 500 patients were recruited and 473 of them (226 men, 247 women) either died or successfully completed the 10-year follow-up and were included in the analysis. The AIP was positively associated, while HDL concentration was negatively associated with the risk of all-cause death adjusted for age, smoking habits, statin use, history of diabetes mellitus, myocardial infarction, stroke and peripheral artery occlusive disease (PAOD) in elderly women but not in men. The LDL, total cholesterol, triacylglycerol and non-HDL concentrations were not associated with the risk of death in both sexes.
The AIP is positively associated with the risk of all-cause death in elderly women with arterial hypertension independent of age, smoking habits, statin therapy and comorbidities.
KeywordsAtherogenic index HDL LDL Risk of mortality Elderly population
Atherogenic index of plasma
Body mass index
Coronary artery disease
Very low-density lipoprotein
Compliance with ethical guidelines
Conflict of interest
M. Bendzala, P. Sabaka, M. Caprnda, A. Komornikova, M. Bisahova, R. Baneszova, D. Petrovic, R. Prosecky, L. Rodrigo, P. Kruzliak, and A. Dukat declare that they have no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
- 2.Lloyd-Jones D, Adams R, Carnethon M, American Heart Association, Stroke Statistics Subcommittee, et al. Heart disease and stroke statistics – 2009 update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2009;119:e21–e181.CrossRefPubMedGoogle Scholar
- 9.Ravnskov U, Diamond DM, Hama R, Hamazaki T, Hammarskjöld B, Hynes N, Kendrick M, Langsjoen PH, Malhotra A, Mascitelli L, McCully KS, Ogushi Y, Okuyama H, Rosch PJ, Schersten T, Sultan S, Sundberg R. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: A systematic review. BMJ Open. 2016;6:e10401.CrossRefPubMedPubMedCentralGoogle Scholar
- 11.van Deventer HE, Miller WG, Myers GL, Sakurabayashi I, Bachmann LM, Caudill SP, Dziekonski A, Edwards S, Kimberly MM, Korzun WJ, Leary ET, Nakajima K, Nakamura M, Shamburek RD, Vetrovec GW, Warnick GR, Remaley AT. Non-HDL cholesterol shows improved accuracy for cardiovascular risk score classification compared to direct or calculated LDL cholesterol in a dyslipidemic population. Clin Chem. 2011;57:490–501.CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Toft-Petersen AP, Tilsted HH, Aarøe J, Rasmussen K, Christensen T, Griffin BA, Aardestrup IV, Andreasen A, Schmidt EB. Small dense LDL particles – a predictor of coronary artery disease evaluated by invasive and CT-based techniques: A case-control study. Lipids Health Dis. 2011;10:21.CrossRefPubMedPubMedCentralGoogle Scholar
- 16.El Harchaoui K, van der Steeg WA, Stroes ES, Kuivenhoven JA, Otvos JD, Wareham NJ, Hutten BA, Kastelein JJ, Khaw KT, Boekholdt SM. Value of low-density lipoprotein particle number and size as predictors of coronary artery disease in apparently healthymenandwomen: the EPIC-Norfolk prospective population study. J Am Coll Cardiol. 2007;49:547–53.CrossRefPubMedGoogle Scholar
- 20.Ohmura H, Mokuno H, Sawano M, Hatsumi C, Mitsugi Y, Watanabe Y, Daida H, Yamaguchi H. Lipid compositional differences of small, dense low-density lipoprotein particle influence its oxidative susceptibility: possible implication of increased risk of coronary artery disease in subjects with phenotype B. Metabolism. 2002;51:1081–7.CrossRefPubMedGoogle Scholar
- 24.Goliasch G, Oravec S, Blessberger H, Dostal E, Hoke M, Wojta J, Schillinger M, Huber K, Maurer G, Wiesbauer F. Relative importance of different lipid risk factors for the development of myocardial infarction at a very young age (≤40 years of age). Eur J Clin Invest. 2012;42:631–6.CrossRefPubMedGoogle Scholar
- 25.Bathum L, Depont Christensen R, Engers Pedersen L, Lyngsie Pedersen P, Larsen J, Nexøe J. Association of lipoprotein levels with mortality in subjects aged 50 + without previous diabetes or cardiovascular disease: A population-based register study. Scand J Prim Health Care. 2013;31:172–80.CrossRefPubMedPubMedCentralGoogle Scholar
- 30.Zuliani G, Cavalieri M, Galvani M, Volpato S, Cherubini A, Bandinelli S, Corsi AM, Lauretani F, Guralnik JM, Fellin R, Ferrucci L. Relationship between low levels of high-density lipoprotein cholesterol and dementia in the elderly. The InChianti study. J Gerontol A Biol Sci Med Sci. 2010;65:559–64.CrossRefPubMedGoogle Scholar