The atherogenic index of plasma is a strong and independent predictor for coronary artery disease in the Chinese Han population

[Effects of ketogenic diet on lipid metabolism in children with intractable epilepsy]

OBJECTIVE

To study the effects of ketogenic diet (KD) on lipid metabolism in children with intractable epilepsy and the risk of atherosclerosis in children treated with KD assessed by changes in lipid profile.

METHODS

The clinical data of 47 children with intractable epilepsy from 2013 to 2017 were collected. Blood lipid levels including triglycerides (TG), total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL), were detected before and 3 months after KD treatment. LDL/HDL ratio, arterial stiffness index (AI), atherogenic index of plasma (AIP) and lipid comprehensive index (LCI) were calculated to assess the risk of atherosclerosis.

RESULTS

After 3 months of KD treatment, the TG and TC levels were slightly higher than those before treatment, and the HDL levels were slightly lower than those before treatment, but the differences were not statistically significant (P>0.05). The LDL levels of the children after 3 months of KD treatment were significantly higher than those before treatment (P<0.05). After 3 months of KD treatment, the LDL/HDL ratio and AI, AIP and LCI levels of the children were increased compared with those before treatment, but only the increase of the LDL/HDL ratio was statistically significant (P<0.05).

CONCLUSIONS

KD treatment may lead to increase in LDL level and LDL/HDL ratio, suggesting that KD treatment may increase the risk of atherosclerosis.

Gender-specific associations between atherogenic index of plasma and the presence and severity of acute coronary syndrome in very young adults: a hospital-based observational study

OBJECTIVE

The value of atherogenic index of plasma (AIP) as a predictive biomarker for coronary artery disease (CAD) remains controversial. In addition, whether AIP is associated with the risk of acute coronary syndrome (ACS) in very young adults has not been well established.

METHODS

We consecutively collected very young adults (≤35 years of age) undergoing coronary angiography (CAG) at Anzhen Hospital, between January 2008 and December 2017. Total of 1, 478 very young participants, including 1, 059 ACS patients and 419 non-CAD subjects, were enrolled in the present study.

RESULTS

Very young patients with ACS had higher AIP level compared with non-CAD participants (0.35 ± 0.30 vs 0.21 ± 0.33, P < 0.001). According to Gensini Score (GS) and number of lesion vessel, patients were divided into four groups, respectively. With the elevated GS score and number of lesion vessels, the AIP level increased gradually (P_{for trend} all< 0.05). Multivariate logistic regression analyses suggested that AIP remained to be independently associated with the presence of ACS and was superior to traditional lipid profiles (for AIP, OR = 2.930, 95% CI = 1.855-4.627, P < 0.001; for total cholesterol, OR = 1.152, 95% CI = 1.048-1.266, P = 0.003; for triglyceride, OR = 1.078, 95% CI = 0.991-1.172, P = 0.079; for low-density lipoprotein cholesterol, OR = 1.046, 95% CI = 1.015-1.078, P < 0.001), after adjustment for other traditional confounders. Moreover, the prevalence of ACS, acute myocardial infarction, unstable angina pectoris and the value of GS were also elevated as AIP quartiles increased (P_{for trend} < 0.001). Subgroup analysis based on gender revealed that AIP was only independently associated with the ACS risk in male.

CONCLUSIONS

AIP was independently associated with the presence and severity of ACS in very young patients in a gender-dependent manner, which might be superior to traditional lipid profiles.

Elevated lipoprotein (a) levels are associated with the acute myocardial infarction in patients with normal low-density lipoprotein cholesterol levels

Elevated lipoprotein (a) [Lp(a)] and coronary artery disease (CAD) risk has been renewed interested in recent years. However, the association between Lp(a) and acute myocardial infarction (AMI) risk in patients with normal low-density lipoprotein cholesterol (LDL-C) levels has yet to been established. A hospital-based observational study including 558 AMI patients and 1959 controls was conducted. Lp(a) level was significantly higher in AMI patients with normal LDL-C levels than that in non-CAD group (median: 134.5 mg/l vs 108 mg/l, P<0.001). According to Lp(a) quartiles (Q1, <51 mg/l; Q2, 51–108 mg/l; Q3, 108–215 mg/l; Q4, ≥215 mg/l), the incidence of AMI increased with the elevated Lp(a) quartiles (P<0.001 and P for trend<0.001). Logistic regression analysis suggested that patients with Q3 and Q4 of Lp(a) values had 1.666 (95%CI = 1.230–2.257, P<0.001) and 1.769 (95%CI = 1.305–2.398, P< 0.001) folds of AMI risk compared with patients with Q1, after adjusting for traditional confounders. Subgroup analyses stratified by gender and age showed that the association only existed in male and late-onset subgroups. In addition, we analyzed the association of Lp(a) with AMI risk in different cut-off values (cut-off 1 = 170 mg/l, cut-off 2 = 300 mg/l). A total of 873 (34.68%) and 432 (17.16%) participants were measured to have higher Lp(a) levels according to cut-off 1 and cut-off 2, respectively. Participants with high Lp(a) levels had 1.418- (cut-off1, 95%CI = 1.150–1.748, P<0.001) and 1.521- (cut-off 2, 95%CI = 1.179–1.963, P< 0.001) folds of AMI risk compared with patients with low Lp(a) levels. The present large-scale study revealed that elevated Lp(a) levels were associated with increased AMI risk in Chinese population with normal LDL-C levels.

On artherogenic index of plasma in sickle cell anaemia patients

INTRODUCTION

Sickle cell anaemia (SCA) is an inherited abnormality of haemoglobin associated with reduced life expectancy. Patients' complications include dyslipideamia. This study was aimed at determining the artherogenic index of plasma (AIP) in sickle cell anaemia patients and compares the value to HbAA controls value. A high AIP is strongly predictive of elevated cardiovascular risk.

METHODS

A comparative study was conducted among SCA patients attending the haematology clinic, Lagos State University Teaching Hospital (LASUTH) and HbAA Phenotype controls. A total of 304 participants were recruited consisting of equal numbers of SCA and HbAA controls. Single lipid profiles were done; logarithms of triglycerides/high density lipoprotein were calculated to obtain AIP and lipid profile ratios established for all participants.

RESULTS

There were lower mean values of Total Cholesterol (TC), High Density Lipoprotein(HDL) and Low Density Lipoprotein (LDL) amongst SCD participants than controls and higher mean values of triglycerides (TG) and Very Low Density Lipoprotein (VLDL) in SCD p < 0.05. The AIP in SCD ranges from -0.62 to 1.32 while that of controls ranges from -0.56 to 0.61.The mean AIP were 0.14 ± 0.29 and -0.009 ± 0.26 in SCD and controls respectively. P value = 0.002.

CONCLUSION

AIP value is higher in sickle cell anaemia than controls, the former have lower mean values of TC, HDL and LDL and higher mean values of TG and VLDL.

Haptoglobin phenotypes with weak antioxidant capacity increase risk factors of cardiovascular disease in Ghanaian HIV-infected patients on highly active antiretroviral therapy

OBJECTIVE

Highly active antiretroviral therapy (HAART) has considerably reduced HIV/AIDS-related morbidity and mortality; however, the therapy has been associated with the development of cardiovascular disease (CVD), and genetic predisposition factors may aggravate disease outcome. This study was aimed at investigating the relationship between haptoglobin phenotypes and risk factors of CVD in HIV patients.

METHODS

A total of 105 HIV sero-positive patients on HAART and 75 HIV-infected HAART-naïve individuals were enrolled in the study. Socio-demographics and clinical characteristics of the participants were obtained using a well-structured questionnaire. Lipid profile, lactate dehydrogenase (LDH) and haptoglobin (Hp) phenotypes were analysed from serum whiles haemoglobin (Hb) level, CD4⁺ cell count and HIV viral RNA load were determined using whole blood.

RESULTS

Atherogenic index of plasma (AIP) was significantly higher in patients on HAART than the naïve group (P < 0.05). Age, BMI, visceral fat, systolic blood pressure LDH and lipid variables strongly and positively correlated with AIP (P < 0.05), with the exception of HDL-c (P < 0.001) which showed a negative correlation. HAART was associated with hypertension (χ²  = 4.33, P = 0.037), hypercholesterolaemia (χ²  = 10.99, P < 0.001), elevated LDL-c (χ² = 10.30, P < 0.001) and decreased HDL-c (χ²  = 3.87, P = 0.09). Hp2-2 and Hp0 collectively was strongly associated with hypertension (OR = 2.54, P = 0.011), obesity (OR = 5.97, P < 0.001) and hypercholesterolaemia (OR = 2.99, P < 0.001).

CONCLUSION

HIV/AIDS patients on HAART expressing Hp phenotypes with weak antioxidant capacity have an increased risk of developing CVD.

Atherogenic index of plasma is related to arterial stiffness but not to blood pressure in normotensive and never-treated hypertensive subjects

BACKGROUND AND AIMS

Atherogenic index of plasma (AIP), defined as the logarithm of triglycerides to high-density lipoprotein cholesterol (HDL-C) ratio, is a strong predictor of future cardiovascular disease. Our aim was to examine the association of AIP with haemodynamic variables in normotensive and never-treated hypertensive subjects in a cross-sectional study.

METHODS

Supine haemodynamics in 615 subjects without antihypertensive and lipid-lowering medications were examined using whole-body impedance cardiography and radial pulse wave analysis. Linear regression analysis was applied to investigate the association of AIP with haemodynamic variables and age, sex, body mass index (BMI), smoking status, alcohol consumption, plasma C-reactive protein, electrolytes, uric acid, low density lipoprotein cholesterol (LDL-C), estimated glomerular filtration rate, and quantitative insulin sensitivity check index.

RESULTS

The demographics and laboratory values of the study population were (mean ± 95% confidence interval): age 44.9 ± 1.0 years, BMI 26.8 ± 0.4 kg/m², office blood pressure 140.6 ± 1.6/89.4 ± 1.0 mmHg, total cholesterol 5.2 ± 0.08, LDL-C 3.1 ± 0.08, triglycerides 1.2 ± 0.08, HDL-C 1.6 ± 0.04 mmol/l, and AIP -0.15 ± 0.02. Age (standardized coefficient Beta 0.508, p < .001) and aortic systolic blood pressure (Beta 0.239, p < .001) presented with the strongest associations with pulse wave velocity. However, AIP was also associated with pulse wave velocity (Beta 0.145, p < .001). AIP was not related with aortic or radial blood pressure, cardiac output, systemic vascular resistance, or augmentation index.

CONCLUSIONS

AIP is directly and independently associated with arterial stiffness, a variable strongly related to cardiovascular risk. This supports more widespread use of AIP in standard clinical cardiovascular disease risk evaluation.

Impact of arsenic exposure on clinical biomarkers indicative of cardiovascular disease risk in Mexican women

An appropriate and precise identification of high-risk individuals to develop cardiovascular diseases (CVD) is of high importance to reduce these kinds of diseases, a major health concern worldwide. Therefore, the aim of this research was to evaluate prognostic CVD biomarkers in Mexican women exposed to inorganic arsenic via drinking water. Then, a cross-sectional study including 190 women was achieved. Urinary arsenic (UAs) levels were analyzed as exposure biomarker to that metalloid. While, plasma asymmetric dimethylarginine (ADMA), adipocyte fatty acid-binding protein (FABP4), adiponectin, and chemerin levels, hypertriglyceridemic waist (HW) phenotype, atherogenic index of plasma (AIP), and Framingham risk score (FRS) were assessed as prognostic CVD biomarkers. Mean UAs level detected in the evaluated urinary samples was 45.0 ± 40.0 μg/g creatinine. In addition, mean plasma ADMA, FABP4, chemerin and adiponectin levels were 0.68 µmol/L, 20.3 ng/mL, 12.5 μg/mL, and 255 ng/mL, correspondingly. Approximately, 54% of women participants displayed an HW phenotype. Regarding AIP and FRS values, 0.12 ± 0.15 and 7.50 ± 8.00 were found, respectively. Besides, strong and significant associations (p < 0.05) between UAs and AIP, ADMA, and FABP4 were distinguished. Also, after a multivariate analysis, the association between those variables persisted after adjustment for traditional risk factors of CVD. In conclusion, according to the results found in this research, the most sensible CVD biomarkers distinguished in this study were AIP, ADMA, and FABP4. Nevertheless, more studies are necessary to confirm the results found in this investigation.

Relationship Between Uric Acid, Proteinuria, and Atherogenic Index of Plasma in Renal Transplant Patients

This study aimed to determine the association of atherogenic index of plasma (AIP) with both hyperuricemia and proteinuria in renal transplant recipients.

MATERIAL AND METHODS

Between the years 2015 and 2017, 61 renal transplant recipients with at least 1 year of follow-up were included in this retrospective cohort study. Uric acid levels of ≥7 mg/dL in men and ≥6 mg/dL in women were accepted as hyperuricemia. The patients were separated into groups according to their serum uric acid and AIP levels.

RESULTS

The prevalence of patients with hyperuricemia was 37.7% (n = 23). The triglycerides (P = .009), AIP (P = .005), proteinuria (P = .04), and C-reactive protein (P = .049) were significantly higher in the hyperuricemic group compared with the nonhyperuricemic group. The levels of uric acid (P = .008) and proteinuria (P = .005) increased significantly with an elevation in AIP levels. Additionally, in multivariate linear regression analysis, uric acid (β = 0.325; P = .008) and estimated glomerular filtration rate (β = -0.291; P = .02) were found to be independently associated factors for proteinuria in renal transplant patients (R² = 0.242; P < .001).

CONCLUSION

We indicated that uric acid, AIP, and proteinuria are closely related. Further prospective studies are needed to evaluate the causal relationship between uric acid, AIP, and proteinuria in this patient group.

Intake of Saturated Fatty Acids Affects Atherogenic Blood Properties in Young, Caucasian, Overweight Women Even without Influencing Blood Cholesterol

Despite a general relation between fat intake and cardiovascular risk factors, the association is often not observed in studies conducted in heterogenic populations, as for population groups, it may differ. The aim of the study was to analyze the associations between dietary fat intake and lipoprotein cholesterol fractions, as well as atherogenic blood properties, in young and middle-aged overweight Caucasian women. In a group of 138 overweight women, the three-day dietary records were assessed, under-reporters were excluded, and lipoprotein cholesterol fractions were analyzed. For the included 24 young (aged 20–40) and 42 middle-age women (aged 40–60), the intakes of fat, saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), polyunsaturated fatty acids (PUFA), and cholesterol, as well as the PUFA/SFA ratio, were assessed. Afterwards, the analysis of associations with blood levels of total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride, as well as the TC/HDL ratio, HDL/LDL, ratio and Atherogenic Index of Plasma (AIP), were conducted. It was stated that the influence of the dietary fat level on lipoprotein cholesterol fractions as well as atherogenic blood properties in overweight Caucasian women is age dependent. For young, overweight, Caucasian women, the influence of the dietary fat level on the lipoprotein cholesterol fractions was not observed; however, SFA intake influenced atherogenic blood properties. For middle-aged, overweight, Caucasian women, the PUFA intake had an especially important influence in increasing the HDL cholesterol level. For overweight Caucasian women, not only should lipoprotein cholesterol fractions be controlled, but also the AIP calculated—especially for younger women.

Anti-obesity effects of Diospyros lotus leaf extract in mice with high-fat diet-induced obesity

Diospyros (D.) lotus has been demonstrated to have antioxidant and anti‑inflammatory properties. The purpose of the present study was to evaluate the effect of D. lotus leaf water extract (DLE) on high‑fat diet (HFD)‑induced obesity in C57BL/6 mice. The present study first investigated the effect of DLE on the lipid accumulation and triglyceride (TG) contents in 3T3‑L1 cells, and the results revealed that treatment with DLE suppressed the lipid accumulation and TG level. Subsequently, the anti‑obesity effects of DLE were investigated in vivo. Oral administration of DLE reduced the body weight gain, food efficiency ratio, and liver and visceral fat weight in mice fed with a HFD. DLE administration in these mice also reduced TG, total cholesterol, low‑density lipoprotein cholesterol, glucose, insulin and leptin levels, as well as the atherogenic index. Furthermore, DLE administration decreased hepatic steatosis, as well as serum aspartate transaminase, alanine transaminase and alkaline phosphatase levels in mice fed with HFD. It was further observed that treatment of the HFD‑fed mice with DLE prevented lipid peroxidation, while it recovered glutathione depletion and the activities of superoxide dismutase, catalase and glutathione peroxidase. In conclusion, the current study suggests that the anti‑obesity effect of DLE may provide positive insights as a potential functional food ingredient for the prevention of obesity.

Serum PCSK9 levels, but not PCSK9 polymorphisms, are associated with CAD risk and lipid profiles in southern Chinese Han population

Background

Genetic and environment factors affect the occurrence and development of coronary artery disease (CAD). Proprotein convertase subtilisin/kexin type 9 (PCSK9), has been investigated extensively in the field of lipid metabolism and CAD. We performed this case-control study to investigate the relationship between serum PCSK9 levels and PCSK9 polymorphisms and lipid levels and CAD risk in a southern Chinese population.

Methods

A hospital-based case-control study with 1, 096 subjects, including 626 CAD patients and 470 controls, were conducted. Genotyping of PCSK9 polymorphisms was performed using polymerase chain reaction-ligase detection reaction (PCR-LDR) method.

Results

The frequencies of the AA, AG and GG genotypes of PCSK9 E670G polymorphism were 90.58, 9.27, and 0.16% in the CAD patients, compared with 88.72, 10.85 and 0.43% in the controls, respectively. No R46L variant was detected in this population. There were no significant differences in genotype and allele frequencies of PCSK9E670G polymorphism between the CAD group and the controls. Serum lipid levels were not significantly different in carriers with the G allele and those with the AA genotype. The median (QR) of PCSK9 concentration was 1205.00 ng/l (577.28–1694.13 ng/l) in cases and 565.87 ng/l (357.17–967.50 ng/l) in controls, respectively. Compared with controls, CAD patients had significantly higher PCSK9 levels (z = 4.559, P < 0.001). After adjusting for age, gender, essential hypertension, diabetic mellitus, smoking and lipid profiles, PCSK9 levels remain significantly associated with increased CAD susceptibility (OR = 1.002, 95% CI = 1.001–1.002, P < 0.001). The correlation analyses showed that serum PCSK9 levels were positively associated with triglyceride (TG), Apo B and atherogenic index of plasma (AIP) levels in controls. No significant association between the PCSK9 E670G polymorphism and serum PCSK9 levels was observed in the CAD group and the controls.

Conclusions

The present study shows that serum PCSK9 levels, but not PCSK9 polymorphisms, are associated with CAD risk in Southern Chinese Han population, and that serum PCSK9 levels are positively associated with AIP.

Electronic supplementary material

The online version of this article (10.1186/s12944-018-0859-5) contains supplementary material, which is available to authorized users.

Atherosclerotic vascular disease and its correlates in stable black South African kidney transplant recipients

Background

Despite remarkable improvement in renal function attributable to kidney transplantation, the burden of cardiovascular disease (CVD) among kidney transplant recipients (KTRs) remains high in the post-transplant period. Aggressive use of statins in KTRs may make lipoprotein ratios correlate better with atherosclerotic vascular disease (AsVD) when compared with traditional lipid profile parameters. We therefore evaluated the clinical and echocardiographic correlates of AsVD among non-diabetic, stable, black KTRs in South Africa.

Methods

This was a cross-sectional study of 41 adult (18–65 years), non-diabetic, stable KTRs and 41 age- and sex-matched healthy controls. An interviewer-administered questionnaire was used to obtain information on participants’ sociodemographic and cardiovascular risk factors. Anthropometric parameters were measured. Urine and blood samples were obtained and analyzed. Echocardiography was performed and carotid intima media thickness (CIMT) was assessed in both right and left carotid arteries. Spearman’s rank correlation and binary logistic regression were performed to determine the relationship between CVD risk factors and AsVD.

Results

AsVD was present in 46.3% of KTRs compared to 17.1% of healthy controls (p = 0.004). Left ventricular hypertrophy was present in 92.7% of the KTRs. There were statistically significant differences in waist–hip ratio, systolic blood pressure, mean arterial pressure, urine albumin–creatinine ratio, serum fibrinogen, serum creatinine, estimated glomerular filtration rate, left atrial diameter, left ventricular mass (LVM), and left ventricular mass index (LVMI) between KTRs and controls. A positive relationship was seen between CIMT and certain risk factors for CVD including LVM, LVMI, and mitral valve deceleration time, (p < 0.001). Castelli index 2 and lipoprotein combine index (LCI) showed positive correlation with CIMT. On multivariate analysis, increasing age and kidney transplant status were independent predictors of AsVD after controlling for other risk factors.

Conclusion

AsVD was common among KTRs. Older age and kidney transplant status independently predicted AsVD. Castelli index 2 and LCI correlated with AsVD better than serum lipid parameters.

Atherogenic index of plasma is a novel and better biomarker associated with obesity: a population-based cross-sectional study in China

Background

Atherogenic index of plasma (AIP) has been reported to be associated with cardiovascular diseases. However no study has yet systematically evaluated the association between AIP and obesity and its advantage in obesity prediction compared with conventional lipid components.

Methods

A total of 6465 participants aged over 30 years were included in this study. Blood lipid components including triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured, and AIP was calculated as log₁₀(TG/HDL-C). Pearson correlation analyses, multivariable logistic analyses and predictive analyses were used to evaluate the association and discrimination ability between AIP, four conventional lipid profiles and obesity.

Results

Subjects in the higher quartiles of AIP all had a significantly increased risk of obesity compared with those in the lowest quartile (P for trend< 0.01). AIP showed a stronger association with obesity than the conventional lipid components as the pearson coefficient reached up to 0.372 and the adjusted odds ratio was 5.55. Using AIP rather than HDL-C and TG significantly improved risk prediction for obesity (AUC improvement = 0.011, P = 0.011; Continuous net reclassification index = 29.55%, P < 0.01; Category net reclassification index = 6.06%; Integrated discrimination improvement = 0.68%, P < 0.01).

Conclusions

Higher AIP level was positively and strongly associated with obesity. AIP is a novel and better biomarker associated with obesity. Controlling the AIP level would be more helpful for the prevention of obesity.

Relationship among adiponectin, insulin resistance and atherosclerosis in non-diabetic hypertensive patients and healthy adults

Adiponectin, which is secreted specifically by adipose tissue, has been shown to have anti-atherogenic and anti-inflammatory effects and to improve insulin resistance (IR). The aim of this study was to determine the correlations among adiponectin, IR and atherosclerosis in non-diabetic hypertensive patients and healthy volunteers. In this case control study, we collected complete demographic data from and measured several laboratory parameters in all enrolled subjects. The homeostasis model of assessment for insulin resistance (HOMA-IR) was calculated as an insulin sensitivity index. The atherogenic index of plasma (AIP), which is calculated as log (triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C)), was a significant predictor of atherosclerosis and was a better predictor of atherosclerosis than low-density lipoprotein cholesterol (LDL-C). Plasma adiponectin, interleukin (IL)-6, monocyte chemoattractant protein-1 (MCP-1) and matrix metalloprotein-9 (MMP-9) concentrations were determined using enzyme-linked immunosorbent assay (ELISA). All data were analyzed using Statistical Product and Service Solutions for Windows (SPSS) 13.0 software. A total of 309 participants were enrolled in the study. Hypertensive patients with IR (n = 93) displayed significantly higher HOMA-IR values and AIPs and lower adiponectin levels than hypertensive patients without IR (n = 121) and healthy adults (n = 95) (P < 0.05). Furthermore, circulating IL-6, MCP-1 and MMP-9 concentrations differed significantly between hypertensive patients and healthy adults (P < 0.05). Additionally, adiponectin levels were found to be inversely correlated with IL-6, MCP-1, and MMP-9 levels; HOMA-IR values; and AIPs in the clinical study. HOMA-IR values and adiponectin and creatinine (Cr) concentrations remained independently associated with AIPs in all participants after adjustment for confounders via multivariate linear regression. Low adiponectin levels are positively correlated with decreased insulin sensitivity, increased pro-inflammatory cytokine production and worsening atherosclerosis in hypertensive patients and healthy adults.

Atherogenic Index in Type 2 Diabetes and Its Relationship with Chronic Microvascular Complications

OBJECTIVE

This study was designed to investigate risk factors related to atherogenic index of plasma (AIP), as well as the relationship between AIP and chronic microvascular complications in patients with type 2 diabetes (T2DM).

METHODS

This study included 2523 patients with T2DM who had not been treated with lipid-lowering drugs and were admitted to the Department of Endocrinology at Zhongnan Hospital, Wuhan University, during the period from January 2015 to February 2018. Anthropometric indicators were measured after overnight fasting. Low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and triglyceride (TG) were detected by enzymatic analysis. Standard 75 g oral glucose tolerance testing was performed to measure 0 and 2 hr plasma levels of glucose and insulin. Insulin sensitivity was assessed with HOMA-IR.

RESULTS

Increase in AIP was associated with an increased risk for hypertension (P < 0.05), HbA_1c (P < 0.05), HOMA-IR (P < 0.05), UA (P < 0.05), and decreased eGFR levels (P < 0.05). Furthermore, AIP values directly correlated with BMI (r = 0.182, P < 0.001), waist circumference (r = 0.129, P < 0.001), blood glucose index (FBG (r = 0.153, P < 0.001), PPBG (r = 0.117, P < 0.001), and HbA_1c (r = 0.074, P < 0.001)), insulin resistance (HOMA-IR; r = 0.112, P < 0.001), and uric acid (UA, r = 0.177, P < 0.001). Multiple logistic regression analysis showed that waist circumference, HOMA-IR, FBG, systolic blood pressure, and UA were independent risk factors for AIP (all P < 0.05). The prevalence of diabetic neuropathy and metabolic syndrome was significantly higher among patients with higher AIP.

CONCLUSION

AIP represents a clinically convenient indicator for the detection of T2DM with high risk of complications and associated diseases and thus is a good predictor and indicator for follow-up monitoring in the treatment of patients with high-risk type 2 diabetes.