Abstract
Background The plasma atherogenic index(AIP)is a well-established risk factor for cardiovascular disease(CVD).However,most existing studies have focused on single AIP measurements and primarily investigated general or diabetic populations.To date,limited research has examined the association between cumulative exposure to the cumulative atherogenic index of plasma(cumAIP)and incident CVD in non-diabetic individuals,both domestically and internationally.Objective This study aimed to investigate the relationship between cumAIP and the risk of incident CVD in non-diabetic individuals.Methods This prospective cohort study included 65 921 non-diabetic employees of the Kailuan Group who participated in and completed health check-ups in 2006,as well as at least two of the subsequent check-ups in 2008 and 2010.Participant data were collected and followed up to calculate cumAIP,which was categorized into quartiles.The cumulative incidence of CVD was calculated using the Kaplan-Meier method and compared across groups using the Log-rank test.The Cox proportional hazards model was employed to assess the association between cumAIP levels and CVD risk.Additionally,restricted cubic spline plots were used to explore the dose-response relationship between cumAIP and CVD risk.Results The study population was divided into four quartiles based on cumAIP:Q1(cumAIP<-0.93,n=16 480),Q2(-0.93≤cumAIP<-0.29,n=16 481),Q3(-0.29≤cumAIP<0.39,n=16 480),and Q4(cumAIP≥0.39,n=16 480).Significant differences were observed in baseline characteristics,including gender,age,blood pressure,BMI,fasting glucose,lipid profiles,high-sensitivity C-reactive protein,smoking,alcohol consumption,physical activity,and medication use(all P<0.05).During a mean follow-up of(10.32±2.07)years,4 137 incident CVD events were recorded.The number of CVD events in Q1,Q2,Q3,and Q4 was 867,947,1 095,and 1 228,respectively.The Log-rank test revealed significant differences in cumulative CVD incidence across quartiles(χ2=73.33,P<0.05).Multivariable Cox proportional hazards analysis showed that compared to Q1,individuals in Q3(HR=1.11,95%CI=1.00-1.24)and Q4(HR=1.16,95%CI=1.02-1.33)had a higher risk of CVD(P<0.05).Restricted cubic spline analysis,adjusted for age,gender,and other confounders,indicated a linear association between cumAIP and CVD risk(overall trend P<0.05,non-linear P=0.97).Sensitivity analyses excluding individuals on antihypertensive medications(n=12 785),lipid-lowering medications(n=871),and those with CVD events within the first two years of follow-up(n=546)confirmed that Q4 remained a significant risk factor for incident CVD(HR=1.18,95%CI=1.03-1.35,P<0.05;HR=1.16,95%CI=1.00-1.34,P<0.05).Conclusion Higher levels of cumAIP are independently associated with an increased risk of incident CVD in non-diabetic individuals.关键词
心血管疾病/累积血浆致动脉粥样硬化指数/危险因素/前瞻性研究/开滦队列研究Key words
Cardiovascular diseases/Cumulative atherogenic index of plasma/Risk factor/Prospective study/Kailuan cohort分类
医药卫生
