Qian Yi1, Ziyang Ren1, Guannan Bai2, Siyu Zhu1, Shuting Li1, Chunlu Li3, Hongjiang Wu4, Yimin Zhu5, Peige Song6. 1. School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China. 2. Children's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China. 3. Medical School, University of Edinburgh, Edinburgh, UK. 4. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region, China. 5. Department of Epidemiology and Biostatistics, School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, China. zhuym@zju.edu.cn. 6. School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Zhejiang University, Hangzhou, 310058, Zhejiang, China. peigesong@zju.edu.cn.
Abstract
AIMS: Atherogenic Index of Plasma (AIP) has been proposed as a novel marker of plasma atherogenicity, but its longitudinal predictive value in type 2 diabetes mellitus (T2DM) remains unclear. We aimed to assess the associations of AIP and its longitudinal transition with T2DM among middle-aged and older Chinese. METHODS: Data were extracted from four rounds of the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018). AIP was calculated as log10 (triglyceride/high-density lipoprotein cholesterol). Participants were classified into high and low AIP groups at baseline, and subsequently into four transition patterns during follow-up: maintained-high, maintained-low, high-to-low, and low-to-high AIP. Multivariable Cox frailty models were applied to explore the longitudinal transition patterns of AIP on the development of T2DM. RESULTS: A total of 8760 subjects without T2DM were selected in 2011, of which 981 developed T2DM until 2018. When compared with people with maintained-low AIP patterns, those with transition patterns of maintained-high AIP, high-to-low AIP, and low-to-high AIP were at around 1.5 times higher risk of T2DM (HRadj = 1.69, 1.32, and 1.47, respectively, all P < 0.05). However, the risk of T2DM did not decrease in the high-to-low AIP group as compared to the maintained-high AIP group. CONCLUSIONS: Three longitudinal AIP transition patterns (maintained-high AIP, high-to-low AIP, and low-to-high AIP) were associated with the development of T2DM. Preventions are needed to combat T2DM at an early dyslipidemic stage.
AIMS: Atherogenic Index of Plasma (AIP) has been proposed as a novel marker of plasma atherogenicity, but its longitudinal predictive value in type 2 diabetes mellitus (T2DM) remains unclear. We aimed to assess the associations of AIP and its longitudinal transition with T2DM among middle-aged and older Chinese. METHODS: Data were extracted from four rounds of the China Health and Retirement Longitudinal Study (2011, 2013, 2015, and 2018). AIP was calculated as log10 (triglyceride/high-density lipoprotein cholesterol). Participants were classified into high and low AIP groups at baseline, and subsequently into four transition patterns during follow-up: maintained-high, maintained-low, high-to-low, and low-to-high AIP. Multivariable Cox frailty models were applied to explore the longitudinal transition patterns of AIP on the development of T2DM. RESULTS: A total of 8760 subjects without T2DM were selected in 2011, of which 981 developed T2DM until 2018. When compared with people with maintained-low AIP patterns, those with transition patterns of maintained-high AIP, high-to-low AIP, and low-to-high AIP were at around 1.5 times higher risk of T2DM (HRadj = 1.69, 1.32, and 1.47, respectively, all P < 0.05). However, the risk of T2DM did not decrease in the high-to-low AIP group as compared to the maintained-high AIP group. CONCLUSIONS: Three longitudinal AIP transition patterns (maintained-high AIP, high-to-low AIP, and low-to-high AIP) were associated with the development of T2DM. Preventions are needed to combat T2DM at an early dyslipidemic stage.