Association between the atherogenic index of plasma and new-onset non-alcoholic fatty liver disease in non-obese participants

Abstract

IntroductionNon-alcoholic fatty liver disease (NAFLD) in the non-obese population accounts for a large proportion of NAFLD. Atherogenic index of plasma (AIP, defined as the logarithm of the triglyceride/high-density lipoprotein cholesterol ratio.) can provide a stronger reflection of dyslipidemia and studies on the longitudinal association between AIP and NAFLD were limited in non-obese participants, especially in different BMI groups.MethodsWe performed a post-hoc analysis of data obtained from the Dryad data repository (Dryad is a nonprofit open database of medicine.) and explored the predictive value of AIP on the risk of NAFLD among non-obese participants.ResultsThis study included 16173 participants with AIP, of which 2322(14.4%) non-obese participants developed into individuals with NAFLD with the 5-year follow-up examination. The difference between AIP quartiles in the cumulative estimation of new-onset NAFLD was significant, and with increased AIP, the cumulative new-onset NAFLD gradually increased. Participants in higher AIP quartiles had a significantly increased risk of NAFLD. In the fully adjusted model 3, hazard ratios of the new-onset NAFLD for subjects in Q2, Q3, and Q4 of AIP were 2.00 (1.59, 2.53), 2.61 (2.09, 3.72), and 4.49 (3.62, 5.57) respectively. Meanwhile, the trend test for the association between AIP quartiles and the new-onset NAFLD presented that AIP quartile was positively and strongly associated with the new-onset NAFLD (adjusted hazard ratio (95%CI) in Model 3: 1.59 (1.51, 1.67), P<0.001). We found that AIP was also positively and strongly associated with new-onset NAFLD in different sex groups and different age groups in female patients. Moreover, the predictive ability of AIP was no significant difference in different sex groups and different age groups in female patients. In the subgroup analysis, we found that in the low BMI population, the predictive effect of AIP for new-onset NAFLD was expanded by 2-3 times for each quality increase of AIP.ConclusionThis study found that AIP was a strong independent risk factor for new-onset NAFLD among non-obese individuals especially in the low BMI participants, and screening for AIP in this population can be used to prevent future NAFLD.

Association between the ZJU index and risk of new-onset non-alcoholic fatty liver disease in non-obese participants: a Chinese longitudinal prospective cohort study

“…Miao et al ( 8) using the same source data as ours investigated the relationship between Remnant lipoprotein cholesterol (RLP-C) and NAFLD, revealing that higher RLP-C levels were associated with an increased risk of NAFLD, with HRs for 1.6 and 1.3 in high and middle RLP-C groups. Li et al (7) involved 16,173 participants and use the atherogenic index of plasma (AIP) to predict NAFLD. Over a span of 5 years, 14.4% of the non-obese individuals developed NAFLD.…”

“…As they often overlook the need for clinical evaluation for NAFLD and are likely to be overlooked in risk assessments for the condition, this population may pose greater challenges than obese individuals. Existing studies have proposed limited indices, including AIP (Atherogenic index of plasma) and RLP-C (Remnant lipoprotein cholesterol), as potential predictors for risk assessment in non-obese population (7,8). First proposed by Wang et al in a cross-sectional study involving 9,602 Chinese participants, the Zhejiang University (ZJU) Index proved to be a proficient tool for screening NAFLD (AUC=0.822) (9,10).…”

Association between atherogenic index of plasma and new-onset stroke in individuals with different glucose metabolism status: insights from CHARLS

“…Min et al have found that individuals with abnormal glucose metabolism and higher AIP levels may have a greater risk of developing cardiovascular diseases [ 25 ]. In addition, higher levels of AIP have been found to be positively correlated with the risk of hypertension and non-alcoholic fatty liver disease, which is potentially influenced by the glucose metabolic states [ 26 – 28 ]. Interestingly, a cross-sectional study has demonstrated a strong association among elevated AIP levels, an increased risk of IR, and the onset of type 2 diabetes [ 6 ].…”

Association between atherogenic index of plasma and new-onset stroke in individuals with different glucose metabolism status: insights from CHARLS

“…Min et al have found that individuals with abnormal glucose metabolism and higher AIP levels may have a greater risk of developing cardiovascular diseases (24). In addition, higher levels of AIP have been shown to be positively correlated with the risk of hypertension and non-alcoholic fatty liver disease, with this relationship potentially in uenced by the glucose metabolic states (25)(26)(27). Interestingly, a cross-sectional study has shown a strong association between elevated AIP levels and an increased risk of insulin resistance and the onset of type 2 diabetes (5).…”