Sex-specific association between atherogenic index of plasma and risk of newly diagnosed abdominal aortic aneurysm: a large population-based cohort study

Abstract Objectives Atherosclerosis of aortic wall has been suggested as a key pathological feature of abdominal aortic aneurysm (AAA). We conducted a first-ever prospective cohort study aiming at assessing the sex-specific association between atherogenic index of plasma (AIP) and risk of newly diag...

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Main Authors: Peng Qiu, Hongbin Guo, Chao Zhu, Yijun Liu, Jiazhen Zheng, Hongji Pu, Xinwu Lu, Qun Huang, Guang Liu, Kaichuang Ye, Zhen Zhou
Format: Article
Language:English
Published: BMC 2025-05-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-02586-4
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author Peng Qiu
Hongbin Guo
Chao Zhu
Yijun Liu
Jiazhen Zheng
Hongji Pu
Xinwu Lu
Qun Huang
Guang Liu
Kaichuang Ye
Zhen Zhou
author_facet Peng Qiu
Hongbin Guo
Chao Zhu
Yijun Liu
Jiazhen Zheng
Hongji Pu
Xinwu Lu
Qun Huang
Guang Liu
Kaichuang Ye
Zhen Zhou
author_sort Peng Qiu
collection DOAJ
description Abstract Objectives Atherosclerosis of aortic wall has been suggested as a key pathological feature of abdominal aortic aneurysm (AAA). We conducted a first-ever prospective cohort study aiming at assessing the sex-specific association between atherogenic index of plasma (AIP) and risk of newly diagnosed AAA. Methods This study included 193,013 male and 226,785 female participants from the UK Biobank. AIP was calculated as a ratio of logarithmically transformed triglycerides to high-density lipoprotein-cholesterol. The outcome of interest was new AAA, identified by ICD-10 and OPCS-4 code, or by AAA-related death. All analyses were sex-stratified: Multivariable Cox proportional-hazard models were employed to assess the association between baseline AIP and AAA risk. Harrell’s c index was estimated to assess the value of AIP added to the discrimination of AAA prediction model. Results Over an average follow-up of 15.3 years, 1931 (1.00%) new AAA cases were recorded in males and 424 (0.19%) in females. In the fully adjusted models, compared with the bottom AIP quintile, HRs (95% CI) of newly diagnosed AAA was 1.67 (1.41, 1.96) in males and 1.75 (1.22, 2.52) in females within the top quintile. Subgroup analysis found smoking status significantly modified the association in females, with association existing only in female ever-smokers. Adding AIP into prediction model comprising age, smoking, and CVD history significantly improved the discrimination in males and male high-risk subgroups and in female ever-smokers (p < 0.05). Conclusions This study highlights the potential of AIP as a biomarker for AAA and its utility in identifying high-risk individuals qualified for AAA screening.
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spelling doaj-art-9c586caa5e08499589845bcf24cd13cb2025-08-20T03:53:21ZengBMCEuropean Journal of Medical Research2047-783X2025-05-0130111210.1186/s40001-025-02586-4Sex-specific association between atherogenic index of plasma and risk of newly diagnosed abdominal aortic aneurysm: a large population-based cohort studyPeng Qiu0Hongbin Guo1Chao Zhu2Yijun Liu3Jiazhen Zheng4Hongji Pu5Xinwu Lu6Qun Huang7Guang Liu8Kaichuang Ye9Zhen Zhou10Department of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of MedicineDepartment of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of MedicineDepartment of Neuroscience, School of Translational Medicine, Monash UniversityDepartment of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of MedicineBioscience and Biomedical Engineering Thrust, Systems Hub, The Hong Kong University of Science and Technology (Guangzhou)Department of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of MedicineDepartment of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of MedicineDepartment of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of MedicineDepartment of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of MedicineDepartment of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of MedicineSchool of Public Health and Preventive Medicine, Monash UniversityAbstract Objectives Atherosclerosis of aortic wall has been suggested as a key pathological feature of abdominal aortic aneurysm (AAA). We conducted a first-ever prospective cohort study aiming at assessing the sex-specific association between atherogenic index of plasma (AIP) and risk of newly diagnosed AAA. Methods This study included 193,013 male and 226,785 female participants from the UK Biobank. AIP was calculated as a ratio of logarithmically transformed triglycerides to high-density lipoprotein-cholesterol. The outcome of interest was new AAA, identified by ICD-10 and OPCS-4 code, or by AAA-related death. All analyses were sex-stratified: Multivariable Cox proportional-hazard models were employed to assess the association between baseline AIP and AAA risk. Harrell’s c index was estimated to assess the value of AIP added to the discrimination of AAA prediction model. Results Over an average follow-up of 15.3 years, 1931 (1.00%) new AAA cases were recorded in males and 424 (0.19%) in females. In the fully adjusted models, compared with the bottom AIP quintile, HRs (95% CI) of newly diagnosed AAA was 1.67 (1.41, 1.96) in males and 1.75 (1.22, 2.52) in females within the top quintile. Subgroup analysis found smoking status significantly modified the association in females, with association existing only in female ever-smokers. Adding AIP into prediction model comprising age, smoking, and CVD history significantly improved the discrimination in males and male high-risk subgroups and in female ever-smokers (p < 0.05). Conclusions This study highlights the potential of AIP as a biomarker for AAA and its utility in identifying high-risk individuals qualified for AAA screening.https://doi.org/10.1186/s40001-025-02586-4Atherogenic index of plasmaAbdominal aortic aneurysmAtherosclerosisSexRisk factor
spellingShingle Peng Qiu
Hongbin Guo
Chao Zhu
Yijun Liu
Jiazhen Zheng
Hongji Pu
Xinwu Lu
Qun Huang
Guang Liu
Kaichuang Ye
Zhen Zhou
Sex-specific association between atherogenic index of plasma and risk of newly diagnosed abdominal aortic aneurysm: a large population-based cohort study
European Journal of Medical Research
Atherogenic index of plasma
Abdominal aortic aneurysm
Atherosclerosis
Sex
Risk factor
title Sex-specific association between atherogenic index of plasma and risk of newly diagnosed abdominal aortic aneurysm: a large population-based cohort study
title_full Sex-specific association between atherogenic index of plasma and risk of newly diagnosed abdominal aortic aneurysm: a large population-based cohort study
title_fullStr Sex-specific association between atherogenic index of plasma and risk of newly diagnosed abdominal aortic aneurysm: a large population-based cohort study
title_full_unstemmed Sex-specific association between atherogenic index of plasma and risk of newly diagnosed abdominal aortic aneurysm: a large population-based cohort study
title_short Sex-specific association between atherogenic index of plasma and risk of newly diagnosed abdominal aortic aneurysm: a large population-based cohort study
title_sort sex specific association between atherogenic index of plasma and risk of newly diagnosed abdominal aortic aneurysm a large population based cohort study
topic Atherogenic index of plasma
Abdominal aortic aneurysm
Atherosclerosis
Sex
Risk factor
url https://doi.org/10.1186/s40001-025-02586-4
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