Association of atherogenic index of plasma and its modified indices with stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: a longitudinal analysis based on CHARLS
Abstract Background The association between the atherogenic index of plasma (AIP), its modified indices (such as AIP-waist circumference [AIP-WC], AIP-waist-to-height ratio [AIP-WHtR], AIP-body mass index[AIP-BMI]), and incident stroke in individuals with cardiovascular-kidney-metabolic (CKM) stages...
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BMC
2025-06-01
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| Series: | Cardiovascular Diabetology |
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| Online Access: | https://doi.org/10.1186/s12933-025-02784-8 |
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| author | Xiaoyan Wang Pengfei Wen Yun Liao Tao Wu Lin Zeng Yuxing Huang Xiaomei Song Zhen Xiong Lisha Deng Dingjun Li Shuchuan Miao |
| author_facet | Xiaoyan Wang Pengfei Wen Yun Liao Tao Wu Lin Zeng Yuxing Huang Xiaomei Song Zhen Xiong Lisha Deng Dingjun Li Shuchuan Miao |
| author_sort | Xiaoyan Wang |
| collection | DOAJ |
| description | Abstract Background The association between the atherogenic index of plasma (AIP), its modified indices (such as AIP-waist circumference [AIP-WC], AIP-waist-to-height ratio [AIP-WHtR], AIP-body mass index[AIP-BMI]), and incident stroke in individuals with cardiovascular-kidney-metabolic (CKM) stages 0–3 remains understudied. This study investigated these associations and their utility for risk stratification. Methods Data from 3697 China Health and Retirement Longitudinal Study (CHARLS) participants (≥ 45 years, CKM stages 0–3) were analyzed. Baseline, cumulative, and changes in AIP and its modified indices (AIP-WC, AIP-WHtR, AIP-BMI) were calculated. Logistic regression, Delong's test, integrated discrimination improvement (IDI), weighted quantile sum (WQS) regression, and mediation analysis were used to assess associations, predictive performance, component contributions, and mediation effects. Results Stroke occurred in 4.8% of participants. Under the fully adjusted Model 3: The third level of AIP, AIP-WHtR, AIP-WC, and AIP-BMI showed increased risks (ORs 1.58 [95% CI 1.05–2.38], 1.99 [95% CI 1.31–3.02], 1.99 [95% CI 1.31–3.02], and 1.92 [95% CI 1.26–2.92], respectively); The third level of cumulative AIP, AIP-WHtR, AIP-WC, and AIP-BMI showed elevated risks (ORs 1.79 [95% CI 1.19–2.69], 2.07 [95% CI 1.37–3.13], 2.01 [95% CI 1.33–3.04], and 1.92 [95% CI 1.27–2.89], respectively); The third category of AIP, AIP-WHtR, AIP-WC, and AIP-BMI changes showed risk increases of 2.28 (95% CI 1.46–3.55), 2.39 (95% CI 1.50–3.79), 2.56 (95% CI 1.61–4.07), and 2.22 (95% CI 1.38–3.56). Modified AIP indices (especially AIP-WHtR) demonstrated superior predictive ability than AIP alone. The association was amplified in advanced CKM (stages 2–3) but not significant in early CKM (stages 0–1). Triglycerides (TG) primarily drove the AIP-WHtR-stroke risk, which was partially mediated by estimated pulse wave velocity (ePWV) (6.48%). Conclusions AIP and its modified indices, especially AIP-WHtR, are significantly associated with incident stroke in CKM stages 0–3. Dynamically monitoring changes in these indices is crucial for stroke risk assessment and stratification, particularly in advanced CKM. TG primarily drives this risk, while ePWV partially mediates the AIP-WHtR-stroke link. Graphic abstract |
| format | Article |
| id | doaj-art-d6ea38d6264b46e7ac0df2b4615c4e12 |
| institution | OA Journals |
| issn | 1475-2840 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
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| series | Cardiovascular Diabetology |
| spelling | doaj-art-d6ea38d6264b46e7ac0df2b4615c4e122025-08-20T02:06:23ZengBMCCardiovascular Diabetology1475-28402025-06-0124111510.1186/s12933-025-02784-8Association of atherogenic index of plasma and its modified indices with stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: a longitudinal analysis based on CHARLSXiaoyan Wang0Pengfei Wen1Yun Liao2Tao Wu3Lin Zeng4Yuxing Huang5Xiaomei Song6Zhen Xiong7Lisha Deng8Dingjun Li9Shuchuan Miao10Department of Clinical Nutrition, The First Affiliated Hospital of Chengdu Medical CollegeDepartment of Dermatology, West China Hospital, Sichuan UniversityDepartment of Neurosurgery, Hospital of Chengdu University of Traditional Chinese MedicineDepartment of Neurosurgery, Hospital of Chengdu University of Traditional Chinese MedicineDepartment of Neurosurgery, Hospital of Chengdu University of Traditional Chinese MedicineDepartment of Neurosurgery, Hospital of Chengdu University of Traditional Chinese MedicineDepartment of Neurosurgery, Hospital of Chengdu University of Traditional Chinese MedicineDepartment of Neurosurgery, Hospital of Chengdu University of Traditional Chinese MedicineDepartment of Neurosurgery, Hospital of Chengdu University of Traditional Chinese MedicineDepartment of Neurosurgery, Hospital of Chengdu University of Traditional Chinese MedicineDepartment of Neurosurgery, Hospital of Chengdu University of Traditional Chinese MedicineAbstract Background The association between the atherogenic index of plasma (AIP), its modified indices (such as AIP-waist circumference [AIP-WC], AIP-waist-to-height ratio [AIP-WHtR], AIP-body mass index[AIP-BMI]), and incident stroke in individuals with cardiovascular-kidney-metabolic (CKM) stages 0–3 remains understudied. This study investigated these associations and their utility for risk stratification. Methods Data from 3697 China Health and Retirement Longitudinal Study (CHARLS) participants (≥ 45 years, CKM stages 0–3) were analyzed. Baseline, cumulative, and changes in AIP and its modified indices (AIP-WC, AIP-WHtR, AIP-BMI) were calculated. Logistic regression, Delong's test, integrated discrimination improvement (IDI), weighted quantile sum (WQS) regression, and mediation analysis were used to assess associations, predictive performance, component contributions, and mediation effects. Results Stroke occurred in 4.8% of participants. Under the fully adjusted Model 3: The third level of AIP, AIP-WHtR, AIP-WC, and AIP-BMI showed increased risks (ORs 1.58 [95% CI 1.05–2.38], 1.99 [95% CI 1.31–3.02], 1.99 [95% CI 1.31–3.02], and 1.92 [95% CI 1.26–2.92], respectively); The third level of cumulative AIP, AIP-WHtR, AIP-WC, and AIP-BMI showed elevated risks (ORs 1.79 [95% CI 1.19–2.69], 2.07 [95% CI 1.37–3.13], 2.01 [95% CI 1.33–3.04], and 1.92 [95% CI 1.27–2.89], respectively); The third category of AIP, AIP-WHtR, AIP-WC, and AIP-BMI changes showed risk increases of 2.28 (95% CI 1.46–3.55), 2.39 (95% CI 1.50–3.79), 2.56 (95% CI 1.61–4.07), and 2.22 (95% CI 1.38–3.56). Modified AIP indices (especially AIP-WHtR) demonstrated superior predictive ability than AIP alone. The association was amplified in advanced CKM (stages 2–3) but not significant in early CKM (stages 0–1). Triglycerides (TG) primarily drove the AIP-WHtR-stroke risk, which was partially mediated by estimated pulse wave velocity (ePWV) (6.48%). Conclusions AIP and its modified indices, especially AIP-WHtR, are significantly associated with incident stroke in CKM stages 0–3. Dynamically monitoring changes in these indices is crucial for stroke risk assessment and stratification, particularly in advanced CKM. TG primarily drives this risk, while ePWV partially mediates the AIP-WHtR-stroke link. Graphic abstracthttps://doi.org/10.1186/s12933-025-02784-8Cardiovascular-kidney-metabolic syndromeStrokeAtherogenic index of plasma-waist circumferenceAtherogenic index of plasma-waist-to-height ratioAtherogenic index of plasma-body mass indexEstimated pulse wave velocity |
| spellingShingle | Xiaoyan Wang Pengfei Wen Yun Liao Tao Wu Lin Zeng Yuxing Huang Xiaomei Song Zhen Xiong Lisha Deng Dingjun Li Shuchuan Miao Association of atherogenic index of plasma and its modified indices with stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: a longitudinal analysis based on CHARLS Cardiovascular Diabetology Cardiovascular-kidney-metabolic syndrome Stroke Atherogenic index of plasma-waist circumference Atherogenic index of plasma-waist-to-height ratio Atherogenic index of plasma-body mass index Estimated pulse wave velocity |
| title | Association of atherogenic index of plasma and its modified indices with stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: a longitudinal analysis based on CHARLS |
| title_full | Association of atherogenic index of plasma and its modified indices with stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: a longitudinal analysis based on CHARLS |
| title_fullStr | Association of atherogenic index of plasma and its modified indices with stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: a longitudinal analysis based on CHARLS |
| title_full_unstemmed | Association of atherogenic index of plasma and its modified indices with stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: a longitudinal analysis based on CHARLS |
| title_short | Association of atherogenic index of plasma and its modified indices with stroke risk in individuals with cardiovascular-kidney-metabolic syndrome stages 0–3: a longitudinal analysis based on CHARLS |
| title_sort | association of atherogenic index of plasma and its modified indices with stroke risk in individuals with cardiovascular kidney metabolic syndrome stages 0 3 a longitudinal analysis based on charls |
| topic | Cardiovascular-kidney-metabolic syndrome Stroke Atherogenic index of plasma-waist circumference Atherogenic index of plasma-waist-to-height ratio Atherogenic index of plasma-body mass index Estimated pulse wave velocity |
| url | https://doi.org/10.1186/s12933-025-02784-8 |
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