The Cumulative Atherogenic Index of Plasma Exposure in Carotid Plaque

Background: Atherogenic index of plasma (AIP) is recognized as a marker for atherosclerosis, but the impact of long-term AIP exposure on carotid plaque remains unknown. Objectives: The objective of the study is to assess the associations of cumulative AIP (cumAIP), incorporating the time course of c...

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Main Authors: YanChen Zhao, MD, XiaoYu Zhao, MD, YunFei Li, MD, YueRuiJing Liu, MD, JinQi Wang, PhD, JiaHe Wang, MD, ZhiYuan Wu, PhD, Jia Liu, PhD, XiuHua Guo, PhD, LiXin Tao, PhD
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:JACC: Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772963X25004879
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author YanChen Zhao, MD
XiaoYu Zhao, MD
YunFei Li, MD
YueRuiJing Liu, MD
JinQi Wang, PhD
JiaHe Wang, MD
ZhiYuan Wu, PhD
Jia Liu, PhD
XiuHua Guo, PhD
LiXin Tao, PhD
author_facet YanChen Zhao, MD
XiaoYu Zhao, MD
YunFei Li, MD
YueRuiJing Liu, MD
JinQi Wang, PhD
JiaHe Wang, MD
ZhiYuan Wu, PhD
Jia Liu, PhD
XiuHua Guo, PhD
LiXin Tao, PhD
author_sort YanChen Zhao, MD
collection DOAJ
description Background: Atherogenic index of plasma (AIP) is recognized as a marker for atherosclerosis, but the impact of long-term AIP exposure on carotid plaque remains unknown. Objectives: The objective of the study is to assess the associations of cumulative AIP (cumAIP), incorporating the time course of cumAIP accumulation with the risk of carotid plaque. Methods: A total of 9,202 participants from the Beijing Health Management Cohort were followed up until December 31, 2021. AIP was calculated as the logarithm of the ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C). CumAIP was derived by averaging AIP values between consecutive visits and multiplying by time intervals. HRs and 95% CIs were calculated using an adjusted Cox proportional hazards model to examine the association between AIP and carotid plaque. Discordance analysis of cumAIP vs TG and HDL-C was performed using the median as the cutoff. External validation was conducted using data from the Atherosclerosis Risk in Communities study. Results: During a median follow-up of 3.99 years, 2,879 participants developed carotid plaque. The highest quartile of cumAIP was significantly associated with an increased risk of carotid plaque (HR: 1.55; 95% CI: 1.36-1.76). Both low TG/high cumAIP group (HR: 1.26; 95% CI: 1.10-1.45) and high HDL-C/high cumAIP group (HR: 1.23; 95% CI: 1.09-1.39) also showed an elevated risk for carotid plaque. Conclusions: CumAIP independently increased the risk of carotid plaque. Discordantly high cumAIP, rather than TG or HDL-C alone, poses a greater risk. Maintaining healthy AIP levels over time may be crucial for preventing atherosclerotic disease.
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spelling doaj-art-b4e30adeab664cddb0bce97954756cc72025-08-20T04:01:57ZengElsevierJACC: Advances2772-963X2025-09-014910206210.1016/j.jacadv.2025.102062The Cumulative Atherogenic Index of Plasma Exposure in Carotid PlaqueYanChen Zhao, MD0XiaoYu Zhao, MD1YunFei Li, MD2YueRuiJing Liu, MD3JinQi Wang, PhD4JiaHe Wang, MD5ZhiYuan Wu, PhD6Jia Liu, PhD7XiuHua Guo, PhD8LiXin Tao, PhD9Department of Epidemiology and Health Statistics, Beijing Key Laboratory of Environment and Aging, School of Public Health, Capital Medical University, Beijing, ChinaDepartment of Epidemiology and Health Statistics, Beijing Key Laboratory of Environment and Aging, School of Public Health, Capital Medical University, Beijing, ChinaDepartment of Epidemiology and Health Statistics, Beijing Key Laboratory of Environment and Aging, School of Public Health, Capital Medical University, Beijing, ChinaDepartment of Epidemiology and Health Statistics, Beijing Key Laboratory of Environment and Aging, School of Public Health, Capital Medical University, Beijing, ChinaDepartment of Epidemiology and Health Statistics, Beijing Key Laboratory of Environment and Aging, School of Public Health, Capital Medical University, Beijing, ChinaDepartment of Epidemiology and Health Statistics, Beijing Key Laboratory of Environment and Aging, School of Public Health, Capital Medical University, Beijing, ChinaDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USACapital Medical University, Yanjing Medical College, Beijing, ChinaDepartment of Epidemiology and Health Statistics, Beijing Key Laboratory of Environment and Aging, School of Public Health, Capital Medical University, Beijing, ChinaDepartment of Epidemiology and Health Statistics, Beijing Key Laboratory of Environment and Aging, School of Public Health, Capital Medical University, Beijing, China; Address for correspondence: Dr Lixin Tao, Department of Epidemiology and Health Statistics, Beijing Key Laboratory of Environment and Aging, School of the Public Health, Capital Medical University, No.10 Xitoutiao, Youanmen Street, Beijing 100069, China.Background: Atherogenic index of plasma (AIP) is recognized as a marker for atherosclerosis, but the impact of long-term AIP exposure on carotid plaque remains unknown. Objectives: The objective of the study is to assess the associations of cumulative AIP (cumAIP), incorporating the time course of cumAIP accumulation with the risk of carotid plaque. Methods: A total of 9,202 participants from the Beijing Health Management Cohort were followed up until December 31, 2021. AIP was calculated as the logarithm of the ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C). CumAIP was derived by averaging AIP values between consecutive visits and multiplying by time intervals. HRs and 95% CIs were calculated using an adjusted Cox proportional hazards model to examine the association between AIP and carotid plaque. Discordance analysis of cumAIP vs TG and HDL-C was performed using the median as the cutoff. External validation was conducted using data from the Atherosclerosis Risk in Communities study. Results: During a median follow-up of 3.99 years, 2,879 participants developed carotid plaque. The highest quartile of cumAIP was significantly associated with an increased risk of carotid plaque (HR: 1.55; 95% CI: 1.36-1.76). Both low TG/high cumAIP group (HR: 1.26; 95% CI: 1.10-1.45) and high HDL-C/high cumAIP group (HR: 1.23; 95% CI: 1.09-1.39) also showed an elevated risk for carotid plaque. Conclusions: CumAIP independently increased the risk of carotid plaque. Discordantly high cumAIP, rather than TG or HDL-C alone, poses a greater risk. Maintaining healthy AIP levels over time may be crucial for preventing atherosclerotic disease.http://www.sciencedirect.com/science/article/pii/S2772963X25004879atherosclerosiscohort studycumulative exposuretime course
spellingShingle YanChen Zhao, MD
XiaoYu Zhao, MD
YunFei Li, MD
YueRuiJing Liu, MD
JinQi Wang, PhD
JiaHe Wang, MD
ZhiYuan Wu, PhD
Jia Liu, PhD
XiuHua Guo, PhD
LiXin Tao, PhD
The Cumulative Atherogenic Index of Plasma Exposure in Carotid Plaque
JACC: Advances
atherosclerosis
cohort study
cumulative exposure
time course
title The Cumulative Atherogenic Index of Plasma Exposure in Carotid Plaque
title_full The Cumulative Atherogenic Index of Plasma Exposure in Carotid Plaque
title_fullStr The Cumulative Atherogenic Index of Plasma Exposure in Carotid Plaque
title_full_unstemmed The Cumulative Atherogenic Index of Plasma Exposure in Carotid Plaque
title_short The Cumulative Atherogenic Index of Plasma Exposure in Carotid Plaque
title_sort cumulative atherogenic index of plasma exposure in carotid plaque
topic atherosclerosis
cohort study
cumulative exposure
time course
url http://www.sciencedirect.com/science/article/pii/S2772963X25004879
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