A J-shaped association between the atherogenic index of plasma and diabetes risk in a Japanese population: a large-scale retrospective cohort study

Abstract Background Atherosclerotic dyslipidemia has been linked to an increased risk of type 2 diabetes (T2D). While previous studies have established an association between the atherogenic index of plasma (AIP) and insulin resistance, there is a notable lack of large-scale cohort studies examining...

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Main Authors: Dong Liu, Mingxing Lou, Yue Tang, Cheng Li, Hao He
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Endocrine Disorders
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Online Access:https://doi.org/10.1186/s12902-025-01951-y
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author Dong Liu
Mingxing Lou
Yue Tang
Cheng Li
Hao He
author_facet Dong Liu
Mingxing Lou
Yue Tang
Cheng Li
Hao He
author_sort Dong Liu
collection DOAJ
description Abstract Background Atherosclerotic dyslipidemia has been linked to an increased risk of type 2 diabetes (T2D). While previous studies have established an association between the atherogenic index of plasma (AIP) and insulin resistance, there is a notable lack of large-scale cohort studies examining the relationship between AIP and the risk of T2D in the general population. Therefore, the present longitudinal study aims to examine the association between AIP and the risk of T2D in a cohort of Japanese adults. Methods This retrospective cohort study included a total of 15,453 adults. To evaluate the association between the AIP and the risk of developing T2D, hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards regression models. Furthermore, potential nonlinear relationships were explored through Cox proportional hazards regression combined with smooth curve fitting techniques. Results During a mean follow-up period of 6.05 years, 373 adults developed T2D. Elevated AIP was independently associated with a significantly higher risk of T2D after adjusting for potential confounding factors (HR: 2.23, 95% CI: 1.55–3.20, P < 0.0001). Furthermore, a J-shaped relationship between AIP and the incidence of T2D was observed. When AIP levels were below − 0.45, no statistically significant association was found between AIP and T2D risk (HR: 0.35, 95% CI: 0.06–1.95, P = 0.2298). In contrast, AIP levels exceeding this threshold were positively associated with an increased risk of T2D (HR: 2.61, 95% CI: 1.77–3.85, P < 0.0001). Conclusion The AIP demonstrates a J-shaped relationship with the risk of developing T2D in Japanese adults. Consequently, maintaining AIP levels below the identified threshold (-0.45) may help reduce their chances of developing diabetes. Clinical trial number Not applicable.
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spelling doaj-art-450d688fb76a46b391be47434d5ae2652025-08-20T03:26:44ZengBMCBMC Endocrine Disorders1472-68232025-06-0125111210.1186/s12902-025-01951-yA J-shaped association between the atherogenic index of plasma and diabetes risk in a Japanese population: a large-scale retrospective cohort studyDong Liu0Mingxing Lou1Yue Tang2Cheng Li3Hao He4Department of Critical Care Medicine, The Fourth Hospital of ChangshaDepartment of Rehabilitation, NHC Key Laboratory of Birth Defect for Research and Prevention (Hunan Provincial Maternal and Child Health Care Hospital)Department of Neurosurgery, The Fourth Hospital of ChangshaDepartment of Critical Care Medicine, The Fourth Hospital of ChangshaDepartment of Critical Care Medicine, The Fourth Hospital of ChangshaAbstract Background Atherosclerotic dyslipidemia has been linked to an increased risk of type 2 diabetes (T2D). While previous studies have established an association between the atherogenic index of plasma (AIP) and insulin resistance, there is a notable lack of large-scale cohort studies examining the relationship between AIP and the risk of T2D in the general population. Therefore, the present longitudinal study aims to examine the association between AIP and the risk of T2D in a cohort of Japanese adults. Methods This retrospective cohort study included a total of 15,453 adults. To evaluate the association between the AIP and the risk of developing T2D, hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional hazards regression models. Furthermore, potential nonlinear relationships were explored through Cox proportional hazards regression combined with smooth curve fitting techniques. Results During a mean follow-up period of 6.05 years, 373 adults developed T2D. Elevated AIP was independently associated with a significantly higher risk of T2D after adjusting for potential confounding factors (HR: 2.23, 95% CI: 1.55–3.20, P < 0.0001). Furthermore, a J-shaped relationship between AIP and the incidence of T2D was observed. When AIP levels were below − 0.45, no statistically significant association was found between AIP and T2D risk (HR: 0.35, 95% CI: 0.06–1.95, P = 0.2298). In contrast, AIP levels exceeding this threshold were positively associated with an increased risk of T2D (HR: 2.61, 95% CI: 1.77–3.85, P < 0.0001). Conclusion The AIP demonstrates a J-shaped relationship with the risk of developing T2D in Japanese adults. Consequently, maintaining AIP levels below the identified threshold (-0.45) may help reduce their chances of developing diabetes. Clinical trial number Not applicable.https://doi.org/10.1186/s12902-025-01951-yAtherogenic index of plasma; type 2 diabetesTriglycerideHigh-density lipoprotein cholesterol
spellingShingle Dong Liu
Mingxing Lou
Yue Tang
Cheng Li
Hao He
A J-shaped association between the atherogenic index of plasma and diabetes risk in a Japanese population: a large-scale retrospective cohort study
BMC Endocrine Disorders
Atherogenic index of plasma; type 2 diabetes
Triglyceride
High-density lipoprotein cholesterol
title A J-shaped association between the atherogenic index of plasma and diabetes risk in a Japanese population: a large-scale retrospective cohort study
title_full A J-shaped association between the atherogenic index of plasma and diabetes risk in a Japanese population: a large-scale retrospective cohort study
title_fullStr A J-shaped association between the atherogenic index of plasma and diabetes risk in a Japanese population: a large-scale retrospective cohort study
title_full_unstemmed A J-shaped association between the atherogenic index of plasma and diabetes risk in a Japanese population: a large-scale retrospective cohort study
title_short A J-shaped association between the atherogenic index of plasma and diabetes risk in a Japanese population: a large-scale retrospective cohort study
title_sort j shaped association between the atherogenic index of plasma and diabetes risk in a japanese population a large scale retrospective cohort study
topic Atherogenic index of plasma; type 2 diabetes
Triglyceride
High-density lipoprotein cholesterol
url https://doi.org/10.1186/s12902-025-01951-y
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