Association of cumulative changes in atherogenic index of plasma and its obesity-related derivatives with cardiovascular disease: emphasis on incremental risk of diabetes status
Authors' conclusion
AIP and its obesity-related derivatives (particularly AIP-CVAI) exhibited significant positive associations with incident CVD risk. The strength of these associations dynamically influenced with cumulative changes in these metrics and significantly modified by diabetic status. Comprehensive analysis using weighted quantile sum and mediation models revealed that cumulative glucose effect partially mediated these associations, while sustained exposure to triglycerides and obesity emerged as primary drivers.
Study context
- Population
- Cardiovascular disease (CVD)-free participants from the China Health and Retirement Longitudinal Study, repeated measurements at Waves 1 and 3
- Participants
- 4,519 participants
- Exposure
- Poor control level or highest cumulative exposure vs better control level or lowest cumulative exposure of atherogenic index of plasma (AIP) and its obesity-related derivatives
- Outcome
- Incident CVD events
- Follow-up
- 8 years' median
Methodological detailsnationally representative cohort, k-means clustering of control levels, weighted quantile sum analysis, mediation analysis
- Nationally representative cohort
- K-means clustering of control levels
- Weighted quantile sum analysis
- Mediation analysis
Main finding
As reported in the abstract
- Poor control / highest cumulative exposure
- OR (poor control/highest cumulative exposure), AIP 1.37/1.34
- Poor control / highest cumulative exposure
- OR (poor control/highest cumulative exposure), AIP-BMI 1.48/1.43
- Poor control / highest cumulative exposure
- OR (poor control/highest cumulative exposure), AIP-WC 1.44/1.42
- Poor control / highest cumulative exposure
- OR (poor control/highest cumulative exposure), AIP-WHtR 1.36/1.42
- Poor control / highest cumulative exposure
- OR (poor control/highest cumulative exposure), AIP-BRI 1.43/1.42
- Poor control / highest cumulative exposure
- OR (poor control/highest cumulative exposure), AIP-CVAI 1.51/1.42
Observational data: associations, not effects.
Further findings
Incremental value of cumulative changes vs baseline
- Cumulative changes further enhanced CVD risk assessment vs baseline assessments
Effect modification by diabetes status
- Diabetic status further amplified the impact of cumulative changes on CVD risk
Component contributions (weighted quantile sum)
- Cumulative TG and cumulative obesity indices had the highest relative contribution weights to CVD events
Mediation by cumulative HbA1c
- Cumulative HbA1c partially mediated the CVD risk associated with cumulative AIP and its derivatives
Original publication
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