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Abstract：
The atherogenic index of plasma (AIP) and cardiovascular disease (CVD) in participants with abnormal glucose metabolism have been linked in previous studies. However, it was unclear whether AIP control level affects the further CVD incidence among with diabetes and pre-diabetes. Therefore, our study aimed to investigate the association between AIP control level with risk of CVD in individuals with abnormal glucose metabolism.
Participants with abnormal glucose metabolism were included from the China Health and Retirement Longitudinal Study. CVD was defined as self-reporting heart disease and/or stroke. Using k-means clustering analysis, AIP control level, which was the log-transformed ratio of triglyceride to high-density lipoprotein cholesterol in molar concentration, was divided into five classes. The association between AIP control level and incident CVD among individuals with abnormal glucose metabolism was investigated multivariable logistic regression analysis and application of restricted cubic spline analysis.
398 (14.97%) of 2,659 participants eventually progressed to CVD within 3 years. After adjusting for various confounding factors, comparing to class 1 with the best control of the AIP, the OR for class 2 with good control was 1.31 (95% CI, 0.90-1.90), the OR for class 3 with moderate control was 1.38 (95% CI, 0.99-1.93), the OR for class 4 with worse control was 1.46 (95% CI, 1.01-2.10), and the OR for class 5 with consistently high levels was 1.56 (95% CI, 1.03-2.37). In restricted cubic spline regression, the relationship between cumulative AIP index and CVD is linear. Further subgroup analysis demonstrated that the similar results were observed in the individuals with agricultural Hukou, history of smoking, diastolic blood pressure ≥ 80mmHg, and normal body mass index. In addition, there was no interaction between the AIP control level and the subgroup variables.
In middle-aged and elderly participants with abnormal glucose metabolism, constant higher AIP with worst control may have a higher incidence of CVD. Monitoring long-term AIP change will contribute to early identification of high risk of CVD among individuals with abnormal glucose metabolism.
Participants with abnormal glucose metabolism were included from the China Health and Retirement Longitudinal Study. CVD was defined as self-reporting heart disease and/or stroke. Using k-means clustering analysis, AIP control level, which was the log-transformed ratio of triglyceride to high-density lipoprotein cholesterol in molar concentration, was divided into five classes. The association between AIP control level and incident CVD among individuals with abnormal glucose metabolism was investigated multivariable logistic regression analysis and application of restricted cubic spline analysis.
398 (14.97%) of 2,659 participants eventually progressed to CVD within 3 years. After adjusting for various confounding factors, comparing to class 1 with the best control of the AIP, the OR for class 2 with good control was 1.31 (95% CI, 0.90-1.90), the OR for class 3 with moderate control was 1.38 (95% CI, 0.99-1.93), the OR for class 4 with worse control was 1.46 (95% CI, 1.01-2.10), and the OR for class 5 with consistently high levels was 1.56 (95% CI, 1.03-2.37). In restricted cubic spline regression, the relationship between cumulative AIP index and CVD is linear. Further subgroup analysis demonstrated that the similar results were observed in the individuals with agricultural Hukou, history of smoking, diastolic blood pressure ≥ 80mmHg, and normal body mass index. In addition, there was no interaction between the AIP control level and the subgroup variables.
In middle-aged and elderly participants with abnormal glucose metabolism, constant higher AIP with worst control may have a higher incidence of CVD. Monitoring long-term AIP change will contribute to early identification of high risk of CVD among individuals with abnormal glucose metabolism.
摘要：
背景：先前的研究已将糖代谢异常的参与者的血浆动脉粥样硬化指数（AIP）和心血管疾病（CVD）联系起来。然而,目前尚不清楚AIP控制水平是否会影响糖尿病患者和糖尿病前期患者心血管疾病的进一步发病率.因此,我们的研究旨在探讨糖代谢异常患者AIP控制水平与CVD风险之间的关系.
方法：糖代谢异常的参与者来自中国健康与退休纵向研究。CVD被定义为自我报告的心脏病和/或中风。使用k均值聚类分析，AIP控制水平,即甘油三酯与高密度脂蛋白胆固醇摩尔浓度的对数转换比，分为五类。研究了糖代谢异常个体中AIP控制水平与心血管事件之间的关系。多变量逻辑回归分析和限制性三次样条分析的应用。
结果：2,659名参与者中的398人（14.97%）最终在3年内进展为CVD。在调整了各种混杂因素后，与具有最佳AIP控制的第1类相比，控制良好的2类OR为1.31(95%CI，0.90-1.90)，中度控制的3类OR为1.38（95％CI，0.99-1.93），控制较差的4类的OR为1.46(95%CI，1.01-2.10)，持续高水平的5类的OR为1.56(95%CI，1.03-2.37)。在受限三次样条回归中，累积AIP指数与CVD呈线性关系。进一步的亚组分析表明，在农业户口的个体中观察到类似的结果，吸烟史,舒张压≥80mmHg，和正常的体重指数。此外,AIP控制水平和亚组变量之间没有交互作用.
结论：在糖代谢异常的中老年参与者中，具有最差控制的恒定较高的AIP可能具有较高的CVD发生率。监测长期AIP变化将有助于在糖代谢异常的个体中早期识别CVD的高风险。
方法：糖代谢异常的参与者来自中国健康与退休纵向研究。CVD被定义为自我报告的心脏病和/或中风。使用k均值聚类分析，AIP控制水平,即甘油三酯与高密度脂蛋白胆固醇摩尔浓度的对数转换比，分为五类。研究了糖代谢异常个体中AIP控制水平与心血管事件之间的关系。多变量逻辑回归分析和限制性三次样条分析的应用。
结果：2,659名参与者中的398人（14.97%）最终在3年内进展为CVD。在调整了各种混杂因素后，与具有最佳AIP控制的第1类相比，控制良好的2类OR为1.31(95%CI，0.90-1.90)，中度控制的3类OR为1.38（95％CI，0.99-1.93），控制较差的4类的OR为1.46(95%CI，1.01-2.10)，持续高水平的5类的OR为1.56(95%CI，1.03-2.37)。在受限三次样条回归中，累积AIP指数与CVD呈线性关系。进一步的亚组分析表明，在农业户口的个体中观察到类似的结果，吸烟史,舒张压≥80mmHg，和正常的体重指数。此外,AIP控制水平和亚组变量之间没有交互作用.
结论：在糖代谢异常的中老年参与者中，具有最差控制的恒定较高的AIP可能具有较高的CVD发生率。监测长期AIP变化将有助于在糖代谢异常的个体中早期识别CVD的高风险。
