Relationship between the cumulative exposure to atherogenic index of plasma and ischemic stroke: a retrospective cohort study

Abstract

Background Atherogenic index of plasma (AIP) has been demonstrated as a surrogate marker for ischemic stroke, but there is limited evidence for the effect of long-term elevation of AIP on ischemic stroke. Therefore, we aimed to characterize the relationship between cumulative exposure to AIP and the risk of ischemic stroke. Methods A total of 54,123 participants in the Kailuan Study who attended consecutive health examinations in 2006, 2008, and 2010 and had no history of ischemic stroke or cancer were included. The time-weighted cumulative AIP (cumAIP) was calculated as a weighted sum of the mean AIP values for each time interval and then normalized to the total duration of exposure (2006–2010). Participants were divided into four groups according to quartile of cumAIP: the Q1 group, ≤−0.50; Q2 group, − 0.50 to − 0.12; Q3 group, − 0.12 to 0.28; and Q4 group, ≥ 0.28. Cox proportional hazard models were used to evaluate the relationship between cumAIP and ischemic stroke by calculating hazard ratios (HRs) and 95% confidence intervals (95% CIs). Results After a median follow-up of 11.03 years, a total of 2,742 new ischemic stroke events occurred. The risk of ischemic stroke increased with increasing quartile of cumAIP. After adjustment for potential confounders, Cox regression models showed that participants in the Q2, Q3, and Q4 groups had significantly higher risks of ischemic stroke than those in the Q1 group. The HRs (95% CIs) for ischemic stroke in the Q2, Q3, and Q4 groups were 1.17 (1.03, 1.32), 1.33 (1.18, 1.50), and 1.45 (1.28, 1.64), respectively. The longer duration of high AIP exposure was significantly associated with increased ischemic stroke risk. Conclusions High cumulative AIP is associated with a higher risk of ischemic stroke, which implies that the long-term monitoring and maintenance of an appropriate AIP may help prevent such events.

Gender differences in the association between changes in the atherogenic index of plasma and cardiometabolic diseases: a cohort study

“…In this study, cumulative AIP was independently positively correlated with CMD, similar to recent research findings. A cohort study involving 54,123 Chinese individuals with an average age of 49.05±11.84 years and a follow-up of 11.3 years found that when the cumulative AIP level was higher than 0.28, the risk of ischemic stroke was 1.45 times higher than when it was lower than -0.50, making cumulative AIP an independent predictor of ischemic stroke [ 24 ]. Data from the China Kailuan study also found that cumulative average AIP was an independent predictor of ischemic and hemorrhagic stroke [ 35 ].…”

“…Although existing studies have shown a positive relationship between single-time AIP levels and the risk of CMD [ 15 , 22 , 23 ], the relationship between cumulative elevation or improvement of AIP and CMD has not been fully clarified. While a few studies have explored the association between cumulative elevation of AIP and the incidence of new strokes [ 24 ], the impact of AIP changes on CMD requires further validation. Hence, this study aims to assess the impact of AIP changes on the incidence of CMD in middle-aged and elderly Chinese individuals, providing new strategies for the prevention and treatment of CMD in this population.…”

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

“…Recent research has explored the association between AIP and cerebrovascular disease, revealing that higher AIP levels are correlated with a higher incidence of atherosclerotic stenosis in the carotid and intracranial arteries [ 10 , 32 ]. In the general population, increased baseline and cumulative AIP levels are associated with a greater risk of ischemic stroke [ 9 , 11 ]. To the best of our knowledge, this study is the first to demonstrate the significant predictive value of baseline AIP level for stroke in individuals with glycemic dysregulation.…”

The association of atherogenic index of plasma with cardiovascular outcomes in patients with coronary artery disease: A systematic review and meta-analysis

“…A recent meta-analysis concluded that higher values of AIP can significantly increase the risk of CAD after adjusting for other risk factors [ 6 ]. Moreover, other studies have revealed the prognostic role of AIP in arterial stiffness, atherosclerotic disease, the risk of AMI, ischemic stroke, and MACE [ 7 – 9 ]. Fu et al demonstrated that diabetic patients with MACE had higher values of AIP, introducing a novel MACE predictor for high-risk patients [ 10 ].…”