Lipids & metabolic liver disease
Associations of the atherogenic index of plasma and its modified indices with the incidence and progression of cardiovascular-liver-metabolic multimorbidity: a prospective cohort study from UK Biobank
Authors' conclusion
Higher AIP and its modified indices were independently associated with increased risks of both incident CLMM and its progression. These indices may help improve CLMM risk stratification and early identification of individuals at elevated risk.
Study context
- Population
- Participants without baseline cardiovascular-liver-metabolic (CLM) diseases, UK Biobank
- Participants
- 370,258 participants
- Exposure
- Per-SD increase in atherogenic index of plasma (AIP) and its seven modified indices
- Outcome
- Incident cardiovascular-liver-metabolic multimorbidity (CLMM)
- Follow-up
- median 16.0-year follow-up
Methodological detailsUK Biobank, multivariable Cox models, exploratory mediation analyses
- UK Biobank
- Multivariable Cox models
- Exploratory mediation analyses
Main finding
As reported in the abstract
Participants who developed cardiovascular-liver-metabolic multimorbidity (CLMM)
8646
Fully adjusted HR per SD increase, range across the eight indices (lowest AIP-VAI, highest AIP and AIP-BMI)
1.18 to 1.68
Observational data: associations, not effects.
Further findings
CLMM progression (AIP-BMI, AIP-WC, AIP-WHtR, per 1-SD increase)
- Risk increase, healthy state to first CLM disease (AIP-BMI, AIP-WC, AIP-WHtR, respectively)
- 38%, 36%, 37%
- Risk increase, first disease to CLMM (AIP-BMI, AIP-WC, AIP-WHtR, respectively)
- 28%, 26%, 27%
- Risk increase, CLMM to triple diseases (AIP-BMI, AIP-WC, AIP-WHtR, respectively)
- 20%, 17%, 18%
Mediation by inflammatory, hepatic and renal biomarkers
- Proportion of associations jointly accounted for
- 28.28 to 45.45%
- Exploratory mediation analyses
Predictive performance (C-index, NRI, IDI)
- All indices improved predictive performance; AIP-BRI and AIP-BMI highest overall, followed by AIP-WC and AIP-WHtR
Original publication
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