Associations of the atherogenic index of plasma and its modified indices with the incidence and progression of cardiometabolic multimorbidity in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: a prospective cohort study
Authors' conclusion
Among individuals with CKM syndrome stages 0-3, AIP-related indices were positively associated with the incidence and progression of CMM, supporting their potential utility for CMM risk stratification within the CKM framework. These indices, particularly AIP-BRI, may provide additional predictive information. Exploratory biomarker findings might provide preliminary clues for future mechanistic research.
Study context
- Population
- UK Biobank participants with cardiovascular-kidney-metabolic (CKM) syndrome stages 0–3 without baseline T2D, coronary heart disease or stroke
- Participants
- 346,868 participants
- Exposure
- Per 1-SD increment in atherogenic index of plasma (AIP)-related indices
- Outcome
- Incident cardiometabolic multimorbidity (CMM): coexistence of at least two of T2D, coronary heart disease, stroke
- Follow-up
- Median 15.9 years
Methodological detailsUK Biobank
- UK Biobank
Main finding
As reported in the abstract
Participants developing cardiometabolic multimorbidity (CMM)
8573
All eight AIP-related indices positively associated with incident CMM; HR per 1-SD increment (all P < 0.001)
1.12 to 1.37
Observational data: associations, not effects.
Further findings
CMM progression (multistate models)
- Stage-specific associations; stronger for transition from baseline to T2D and from single CMD to CMM involving coronary heart disease (CHD) (all P < 0.001)
Incremental predictive value
- Adding each index to conventional risk factors improved discrimination and reclassification; AIP-body roundness index (AIP-BRI) showed the greatest overall incremental predictive value
Exploratory biomarker analyses
- Inflammatory, liver and renal biomarkers jointly accounted for share of associations
- 32.5-46.4%
- Should not be interpreted as evidence of causal mediation
Original publication
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