背景:血浆动脉粥样硬化指数(AIP)与糖尿病的发病密切相关,肥胖是2型糖尿病(T2DM)的重要危险因素。然而,在超重和肥胖人群中,AIP和T2DM之间的关联很少被研究.因此,本研究旨在探讨超重和肥胖2型糖尿病患者的这种相关性.
方法:本横断面分析使用了2018年1月至2023年12月在河南省人民医院筛查的40,633名体重指数(BMI)≥24kg/m2的参与者的数据。根据T2DM标准,参与者被分为超重和肥胖个体,有和没有糖尿病。AIP,我们的因变量,使用公式log10[(TGmol/L)/HDL-C(mol/L)]计算。我们使用多变量逻辑回归研究超重和肥胖个体的AIP和T2DM之间的关联。亚组分析,广义加法模型,平滑曲线拟合,和阈值效应分析。此外,介导分析评估了炎症细胞在AIP相关T2DM中的作用。
结果:超重和肥胖的T2DM患者的AIP水平高于无糖尿病患者。在调整了混杂因素后,我们的结果表明,在超重和肥胖个体中,AIP与T2DM风险之间存在显著关联(比值比(OR)=5.17,95%置信区间(CI)4.69~5.69).值得注意的是,基线AIP较高(Q4组)的参与者患T2DM的风险明显高于Q1组,OR为3.18(95%CI2.94-3.45)。亚组分析显示AIP和T2DM之间的相关性随着年龄的增加而降低(交互作用P<0.001)。在超重和肥胖人群中,AIP和T2DM风险之间的关联显示出J形非线性模式,AIP>-0.07表明T2DM风险显著增加。各种炎症细胞,包括中性粒细胞,白细胞,和单核细胞,介导4.66%,4.16%,和1.93%的协会,分别。
结论:在超重和肥胖个体中,AIP与T2DM独立相关,表现出非线性关联。此外,AIP和T2DM之间的相关性随着年龄的增长而降低.多种类型的炎症细胞介导这种关联。
BACKGROUND: The atherogenic index of plasma (AIP) is closely associated with the onset of diabetes, with obesity being a significant risk factor for type 2 diabetes mellitus (T2DM). However, the association between the AIP and T2DM in overweight and obese populations has been infrequently studied. Therefore, this study aimed to explore this association in overweight and obese individuals with T2DM.
METHODS: This cross-sectional analysis utilized data from 40,633 participants with a body mass index (BMI) ≥ 24 kg/m2 who were screened from January 2018 to December 2023 at Henan Provincial People\'s Hospital. Participants were categorized into groups of overweight and obese individuals with and without diabetes according to the T2DM criteria. The AIP, our dependent variable, was calculated using the formula log10 [(TG mol/L)/HDL-C (mol/L)]. We investigated the association between the AIP and T2DM in overweight and obese individuals using multivariate logistic regression, subgroup analysis, generalized additive models, smoothed curve fitting, and threshold effect analysis. Additionally, mediation analysis evaluated the role of inflammatory cells in AIP-related T2DM.
RESULTS: Overweight and obese patients with T2DM exhibited higher AIP levels than those without diabetes. After adjusting for confounders, our results indicated a significant association between the AIP and the risk of T2DM in overweight and obese individuals (odds ratio (OR) = 5.17, 95% confidence interval (CI) 4.69-5.69). Notably, participants with a high baseline AIP (Q4 group) had a significantly greater risk of T2DM than those in the Q1 group, with an OR of 3.18 (95% CI 2.94-3.45). Subgroup analysis revealed that the association between the AIP and T2DM decreased with increasing age (interaction P < 0.001). In overweight and obese populations, the association between AIP and T2DM risk displayed a J-shaped nonlinear pattern, with AIP > - 0.07 indicating a significant increase in T2DM risk. Various inflammatory cells, including neutrophils, leukocytes, and monocytes, mediated 4.66%, 4.16%, and 1.93% of the associations, respectively.
CONCLUSIONS: In overweight and obese individuals, the AIP was independently associated with T2DM, exhibiting a nonlinear association. Additionally, the association between the AIP and T2DM decreased with advancing age. Multiple types of inflammatory cells mediate this association.