Lipids & metabolic liver disease
Association between atherogenic index of plasma (AIP) and all-cause and cardiovascular mortality in patients with metabolic dysfunction-associated steatotic liver disease (MASLD): a cohort study based on NHANES 1999–2018
Authors' conclusion
In US patients with MASLD, baseline AIP exhibited a J-shaped relationship with ACM. An AIP > 1.71 may warrant early intervention. Baseline AIP may be an effective predictor of future ACM and CVM in individuals aged < 60. However, further research is required to validate these findings.
Study context
- Population
- US patients with MASLD, NHANES 1999–2018, mortality linked to National Death Index through 31 December 2019
- Participants
- 6,567 patients
- Exposure
- Higher vs lower AIP
- Outcome
- All-cause mortality (ACM) and CVD mortality (CVM)
- Follow-up
- Median 122 months
Methodological detailsNHANES 1999–2018, linked to National Death Index, multivariate Cox models, restricted cubic spline
- NHANES 1999–2018
- Linked to National Death Index
- Multivariate Cox models
- Restricted cubic spline
Main finding
As reported in the abstract
Higher AIP and CVM risk, adjusted HR
1.34
95% CI 1.01–1.79P = 0.05
AIP and ACM, adjusted HR (95% CI 0.89-1.24, P = 0.50); no significant association
1.05
Observational data: associations, not effects.
Further findings
ACM, restricted cubic spline (RCS) analysis: J-shaped relationship (threshold 1.71)
- ACM risk when AIP > 1.71, HR
- 1.48 (95% CI 1.14-1.92, P = 0.003)
ACM, subgroup age < 60 years
- Interaction AIP × age, Pfor_interaction
- 0.018
- Elevated AIP and ACM in age < 60, HR
- 1.25 (95% CI 1.04-1.51; P = 0.018)
Mediation of AIP effect on ACM / CVM
- HbA1c mediated, ACM / CVM
- 73.17% / 42.98%
- Neutrophils mediated, ACM / CVM
- 20.10% / 12.48%
- Hypertension mediated, ACM / CVM
- 9.80% / 11.96%
- Sensitivity analysis confirmed robustness
Original publication
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