Lipids & metabolic liver disease
Association of the atherogenic index of plasma and its integrative novel adiposity-based composites with all-cause and cardiovascular mortality in individuals with cardiovascular-kidney-metabolic syndrome: novel adiposity-derived atherogenic index of plasma (AIP) indices provide modest incremental prognostic information
Authors' conclusion
Across the CKM spectrum, higher AIP-based adiposity composite indices, particularly AIP-BRI, were associated with increased risks of all-cause and cardiovascular mortality, especially among younger individuals. However, their incremental predictive improvement was modest, suggesting that these indices may serve as supplementary exploratory markers rather than stand-alone tools for CKM risk stratification.
Study context
- Population
- US adults with cardiovascular-kidney-metabolic (CKM) syndrome stages 0–4 (2023 American Heart Association (AHA) Presidential Advisory), National Health and Nutrition Examination Survey (NHANES) 1999–2018
- Participants
- 22,587 adults
- Exposure
- Per SD increase in AIP and AIP-based adiposity composites
- Outcome
- All-cause and cardiovascular mortality (National Death Index linkage)
Methodological detailsprospectively collected data, survey-weighted
- Prospectively collected data
- Survey-weighted
Main finding
As reported in the abstract
AIP-BRI, HR per SD
1.09 (1.05-1.14) (95% CI)
AIP-WWI, HR per SD
1.07 (1.02-1.11) (95% CI)
AIP-ABSI, HR per SD
1.07 (1.02-1.11) (95% CI)
AIP, HR per SD
1.06 (1.01-1.10) (95% CI)
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Baseline composites, non-survivors vs survivorsHigher in non-survivors | P < 0.001 |
Cardiovascular mortality
- AIP-BRI, HR per SD
- 1.17 (1.09-1.27) (95% CI)
- AIP-WWI, HR per SD
- 1.11 (1.03-1.21) (95% CI)
- AIP-ABSI, HR per SD
- 1.11 (1.02-1.20) (95% CI)
- AIP, HR per SD
- 1.10 (1.02-1.20) (95% CI)
- Model 2
Nonlinearity (restricted cubic splines (RCS))
- J-shaped associations; clinical risk threshold for AIP-BRI
- 1.57
Subgroups by age
- Associations most evident in participants aged < 50 years
Incremental prognostic value: adding body roundness index (BRI) to AIP, cardiovascular mortality
- Net reclassification improvement (NRI) (statistically significant but modest)
- 3.10%
Original publication
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