Association of atherogenic index of plasma and its modified indices with stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: a longitudinal analysis based on China Health and Retirement Longitudinal Study (CHARLS)
Authors' conclusion
AIP and its modified indices, especially AIP-WHtR, are significantly associated with incident stroke in CKM stages 0-3. Dynamically monitoring changes in these indices is crucial for stroke risk assessment and stratification, particularly in advanced CKM. TG primarily drives this risk, while ePWV partially mediates the AIP-WHtR-stroke link.
Study context
- Population
- CHARLS participants aged ≥45 years with cardiovascular-kidney-metabolic (CKM) stages 0–3
- Participants
- 3,697 participants
- Exposure
- Third vs lower levels of atherogenic index of plasma (AIP) and its modified indices
- Outcome
- Incident stroke
Methodological detailslongitudinal, CHARLS
- Longitudinal
- CHARLS
Main finding
As reported in the abstract
Incident stroke, fully adjusted Model 3
- Stroke occurrence
- 4.8%
- Baseline AIP, third level: OR
- 1.58 (95% CI 1.05-2.38)
- Baseline AIP-WHtR, third level: OR
- 1.99 (95% CI 1.31-3.02)
- Baseline AIP-WC, third level: OR
- 1.99 (95% CI 1.31-3.02)
- Baseline AIP-BMI, third level: OR
- 1.92 (95% CI 1.26-2.92)
- Cumulative AIP, third level: OR
- 1.79 (95% CI 1.19-2.69)
- Cumulative AIP-WHtR, third level: OR
- 2.07 (95% CI 1.37-3.13)
- Cumulative AIP-WC, third level: OR
- 2.01 (95% CI 1.33-3.04)
- Cumulative AIP-BMI, third level: OR
- 1.92 (95% CI 1.27-2.89)
- AIP change, third category: risk increase
- 2.28 (95% CI 1.46-3.55)
- AIP-WHtR change, third category: risk increase
- 2.39 (95% CI 1.50-3.79)
- AIP-WC change, third category: risk increase
- 2.56 (95% CI 1.61-4.07)
- AIP-BMI change, third category: risk increase
- 2.22 (95% CI 1.38-3.56)
Observational data: associations, not effects.
Further findings
Predictive ability
- Modified AIP indices (especially AIP-WHtR) predicted better than AIP alone
CKM stage subgroups
- Association amplified in advanced CKM (stages 2-3), not significant in early CKM (stages 0-1)
Components and mediation of AIP-WHtR–stroke risk
- Proportion mediated by estimated pulse wave velocity (ePWV)
- 6.48%
- Triglycerides (TG) primarily drove the risk
Original publication
Association of atherogenic index of plasma and its modified indices with stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: a longitudinal analysis based on CHARLS. Cardiovasc Diabetol. Published 14 June 2025. doi:10.
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