Cardiorespiratory Fitness, Physical Activity, Sedentary Time and Its Association with the Atherogenic Index of Plasma in Chilean Adults: Influence of the Waist Circumference to Height Ratio

The association between blood glucose levels and lipids in the general adult population: results from NHANES (2005-2016)

OBJECTIVE

Although abnormal lipid metabolism is one of the major risk factors for diabetes, the correlation between lipids and glucose is rarely discussed in the general population. The differences in lipid-glucose correlations across gender and ethnicity have been even more rarely studied. We examined the association between fasting blood glucose (FBG) and lipids, including triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoprotein B (ApoB), using 6,093 participants aged 20 years or older from the National Health and Nutrition Examination Survey (NHANES).

METHODS

Analyses were performed using multiple logistic regression and generalised additive models.

RESULTS

When other confounders were considered, we found that fasting glucose was positively correlated with triglycerides and negatively correlated with HDL-C, whereas total cholesterol, LDL-C cholesterol, and fasting glucose were related to each other in a U-curve fashion, with inflection points of 5.17 mmol/L and 2.3 mmol/L, respectively.This relationship persisted in subgroups of different sexes and races. A positive correlation was found between fasting glucose and ApoB, but subgroup analyses revealed that this relationship was not correlated across gender and race.

CONCLUSION

In the general population, fasting blood glucose levels were positively correlated with TG, negatively correlated with HDL-C, and U-shaped with total cholesterol and LDL-C. The likelihood of developing diabetes was 40% higher when LDL-C was greater than 2.3 mmol/L than in patients with LDL-C less than 2.3 mmol/L.

Evaluation of the Atherogenic Index of Plasma to Predict All-Cause Mortality in Elderly With Acute Coronary Syndrome: A Long-Term Follow-Up

The Atherogenic Index of Plasma (AIP) is associated with coronary artery disease (CAD) and acute coronary syndrome (ACS), but the relationship between AIP and ACS in elderly patients remains unclear. We investigated the prognostic capability of AIP for in-hospital and long-term mortality in elderly patients with ACS undergoing coronary angiography (CA). We analyzed 627 patients with ACS over 75 years of age who were admitted to our clinic between April 2015 and December 2022 and underwent CA. The primary clinical endpoints were in-hospital, 30-day, 1-year, and long-term mortality. The median follow-up time was 27 months. AIP was defined as log (triglyceride/high-density lipoprotein cholesterol). In-hospital mortality rates for patients with AIP ≤.1 and AIP >.1 were 4.7% and 17.6% (P < .001), 30-day mortality rates were 8.7% and 32.2% (P = .01), 1-year mortality rates were 12.1% and 45.1% (P < .001), and long-term mortality rates were 47.3% and 67.5% (P < .001), respectively. Multivariate Cox regression analysis revealed AIP, age, left ventricle ejection fraction (LVEF), admission creatinine, and Killip ≥2 as independent predictors for long-term mortality. AIP can predict in-hospital and long-time all-cause mortality in elderly patients with ACS undergoing CA. Age, LVEF, admission creatinine, and Killip ≥2 are additional factors that predict long-term all-cause mortality.

A Novel Score for an Old Enemy: Atherogenic Plasma Index Predicts In-Stent Restenosis among Stable Angina Pectoris Patients

Objectives

Although the association of Atherogenic index of plasma (AIP) with coronary artery disease (CAD) and atherosclerosis is known, the relationship between AIP and in-stent restenosis (ISR) remains unclear. We aimed to investigate the relationship between AIP and ISR in patients with stable angina pectoris (SAP) treated with drug-eluting stent (DES).

Methods

Patients with a history of DES implantation following stable angina were evaluated between January 2015 and November 2019 in this observational and retrospective study. 608 eligible patients were dichotomized into ISR+ (n=241) and ISR- (n=367). ISR was defined as the presence of 50% or greater stenosis. AIP was defined as log [TG/HDL-C].

Results

AIP levels were significantly higher in patients who developed ISR compared with those who did not (0.33 [0.15-0.52] vs 0.06 [-0.08-0.21] respectively, p<0.001). The AUC value of AIP levels for predicting ISR was 0.746 (p<0.001). Multivariate logistic regression analysis revealed that AIP, diabetes mellitus, higher LDL-C levels and lower LVEF values were independently associated with ISR.

Conclusion

Multivariate analysis revealed that AIP was strongly independently associated with ISR. Using this novel inexpensive and easily calculable index may provide early recognition of ISR in patients with SAP who were treated with DES.

The relation between atherogenic index of plasma and cardiovascular outcomes in prediabetic individuals with unstable angina pectoris

BACKGROUND

The atherogenic index of plasma (AIP) is a novel biomarker associated with atherosclerosis, and an important risk factor for atherosclerosis, but its relation with cardiovascular prognosis in prediabetic patients with unstable angina pectoris (UAP) is still uncertain.

METHODS

This study included 1096 prediabetic patients with UAP who were subjected to follow-up for a maximum of 30 months, with cardiac death, refractory angina, and non-fatal myocardial infarction (MI) being the primary cardiovascular endpoints.

RESULTS

A significantly increased AIP was observed for the group with primary cardiovascular endpoints. Kaplan-Meier curves corresponding to these endpoints revealed pronounced differences between these two AIP groups (Log-rank P < 0.001). Multivariate Cox proportional hazards analyses highlighted AIP as being independent related to this primary endpoint (HR 1.308, 95% CI: 1.213-1.412, P < 0.001). AIP addition to the baseline risk model improved the prediction of the primary endpoint (AUC: baseline model, 0.622, vs. baseline model + AIP, 0.739, P < 0.001).

CONCLUSIONS

AIP could be used to predict cardiovascular events in prediabetic individuals with UAP.

Association of Systemic Immune Inflammation Index with Estimated Pulse Wave Velocity, Atherogenic Index of Plasma, Triglyceride-Glucose Index, and Cardiovascular Disease: A Large Cross-Sectional Study

In the U.S. general population, there is a lack of understanding regarding the association between the systemic immune inflammation (SII) index and estimated pulse wave velocity (ePWV), atherogenic index of plasma (AIP), and triglyceride-glucose (TyG) index and cardiovascular disease (CVD). As a result, the objective of our research was to investigate the association between the SII index and ePWV, AIP, and TyG index and incident CVD. We used the National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2018 to conduct this study. The correlation between the SII index and ePWV, AIP, and TyG index was examined using generalized additive models with smooth functions. In addition, the association between SII index and triglyceride (TC), high-density lipoprotein cholesterol (HDL-C), and fast glucose (FBG) also were explored. Finally, we further performed multivariable logistic regression analysis, restricted cubic spline (RCS) plots, and subgroup analysis to study the connection between the SII index and CVD. Our analysis included 17389 subjects from the NHANES database. A substantial positive association existed between SII, WV, and the TyG index. In addition, with the increase of the SII index, AIP showed a trend of decreasing first, then rising, and then decreasing. The SII index was inversely and linearly associated with triglyceride (TG), while positively and linearly associated with fast glucose (FBG). However, high-density lipoprotein cholesterol (HDL-C) had a tendency of first declining, then climbing, and finally falling with the rise in the SII index. After adjusting for potential confounders, compared with the lowest quartiles, the odds ratios with 95% confidence intervals for CVD across the quartiles were 0.914 (0.777, 1.074), 0.935 (0.779, 1.096), and 1.112 (0.956, 1.293) for SII index. The RCS plot showed an inverse U-shaped curve relationship between the SII index and CVD. Overall, this study found a strong correlation between a higher SII index and ePWV and the TyG index. Additionally, these cross-sectional data also revealed a U-shaped connection between the SII index and CVD.

Association between atherogenic index of plasma and in-hospital mortality in patient with STEMI undergoing primer PCI

Aim: Dyslipidemia is an established risk factors for cardiovascular disease. Increased triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) levels, and decreased HDL-C levels were associated with increased cardiovascular risk. Recently, comprehensive lipid profile indices derived from these conventional parameters have attracted to attention. Atherogenic index of plasma (AIP) is one of the indices calculated as the logarithm of TG/HDL-C levels and, it is accepted as an alternative and simple marker of plasma atherogenicity. Although various studies demonstrated that their relationship with these lipid indices and clinical outcomes in patients with acute coronary syndrome, this situation is not yet clear in acute ST-elevation myocardial infarction (STEMI) patients undergoing primer percutaneous coronary intervention (pPCI). The aim of this study was to focus on the relationship traditional lipid levels and non-traditional comprehensive lipid indices and in hospital-mortality in patients with STEMI after pPCI. In this study, it is planned to investigate the relationship of AIP with early mortality in STEMI patients undergoing primary percutaneous coronary intervention. Material and Methods: In this retrospective, single center, hospital-based study, between January 2019 and April 2021, a total of 873 consecutive STEMI patients (705 men; median age 59 years), whose undergoing pPCI, are enrolled. The patients were divided into two groups according to in-hospital mortality status namely survivor and deceased. Conventional lipid values were measured and non-traditional lipid indexes including non-HDL-C [Total cholesterol minus HDL-C], Total cholesterol/HDL-C, LDL-C/HDL-C, atherogenic index (AI) [non-HDL-C/HDL-C], lipoprotein combine index (LCI) [Total cholesterol*TG*LDL-C/HDL-C] and atherogenic index of plasma (AIP) [Log(TG/HDL-C)] were calculated. Angiographic evaluations of the patients were performed through the hospital automation system. Results: AIP was significantly higher in hospital mortality patients compared to survivor group (0.59, 0.47, p=0.006, respectively). AI, non-HDL-C, Total cholesterol/HDL-C ratio, LDL-C/HDL-C ratio and LCI measurements were similar between two groups. The cut-off value of the AIP (0.50) was associated with 70% sensitivity and 52% specificity for predicts in-hospital mortality. Multivariate logistic regression model yielded AIP (OR: 3.77, 95% CI: 1.34–10.6, p < 0.012) as independent predictor of in-hospital mortality. Conclusion: AIP predicts in-hospital mortality in patients with STEMI undergoing pPCI. AIP, which can be calculated easily from complete blood, can be beneficial in the prognostication of these patients.

Metabolic syndrome and body weight in people living with HIV infection: analysis of differences observed in three different cohort studies over a decade

OBJECTIVES

The aim of this study was to assess the incidence of being overweight and metabolic syndrome (MS) among people living with HIV (PHIV) in three different cross-sectional studies conducted over three different periods: 2005, 2011 and 2015.

METHODS

This was a multi-centre, nationwide study. Data were collected in three studies from the CISAI group - SIMOne, HIV-HY and STOPSHIV - and included a total of 3014 PHIV. Logistic regression [odds ratio (OR), 95% confidence interval (CI)] was used to account for age and gender difference among three groups when comparing MS prevalence and being overweight; potential confounders were accounted for by including them in the regression equation.

RESULTS

Overall, the mean age was 46.9 ± 10.2 years, and men comprised 73.3% of participants. Comparing 2005, 2011 and 2015, MS was present in 34.5%, 33.0% and 29.3% of PHIV, respectively. Adjusted OR for MS was 0.64 (95% CI: 0.52-0.78) in 2011 and 0.56 (95% CI: 0.46-0.69) in 2015 compared with 2005, while BMI (kg/m² ) increased from 23.6 in 2005, 24.5 in 2011 and 24.5 in 2015, with a concomitant increase of being overweight from 29.4% to 39.5% to 39.6% (p < 0.0001).

CONCLUSIONS

In recent years, PHIV have had a significantly improved metabolic profile compared with previously, despite increasing weight and BMI.

Urolithiasis Develops Endothelial Dysfunction as a Clinical Feature

An increased risk of cardiovascular morbidity has been reported in lithiasic patients. In this context, endothelial dysfunction (ED), an earlier status of atherogenesis, has been identified in hyperoxaluria rat models of urolithiasis. Objective: The purpose of this study was to determine the endothelial vascular function in patients with urolithiasis in relation to systemic inflammatory, oxidative stress, and vascular function serum markers. Methods: A cross-sectional study was performed between 27 urolithiasic patients, matched for age and sex, with 27 healthy patients. Endothelial function was assessed by measuring flow-mediated dilation (Celermajer method). Fasting blood was collected to determine metabolic parameters (glucose and lipid profile), along with serum CRP, IL-6, MDA, ADMA, and VCAM-1. Results: Both the control and urolithiasis groups were homogenous in anthropometric, exploration, and general laboratory measures. Flow-mediated dilation (%FMD) was 11.85% (SE: 2.78) lower in the lithiasis group (p < 0.001). No significant differences were achieved between groups when CRP, IL-6, MDA, ADMA, and VCAM-1 were compared, although slightly higher values of CRP, ADMA, and VCAM-1 were detected in the lithiasic group. A correlation was not reached in any of the serum markers when they were related to flow-mediated values, although a slight negative correlation trend was observed in MDA, VCAM-1, and IL-6 values. Conclusions: Endothelial dysfunction constitutes an important disorder related to urolithiasis patients. It must be considered as an early feature responsible for future cardiovascular events. Our study did not find a significant association between inflammatory, oxidative stress, endothelial serum markers, and flow-mediated dilation.

Clinical Utility of the Logarithmically Transformed Ratio of Triglycerides-to- High-Density Lipoprotein Cholesterol and Its Relationship with Other Atherosclerosis-Related Lipid Factors in Type 2 Diabetes

Background: Elevated triglyceride (TG) levels and reduced high-density lipoprotein-cholesterol (HDL-c) levels indicate lipid abnormalities, but their levels alone do not reflect the actual status of plasma atherogenicity and cardiovascular disease risk (CVD). TG and HDL-c levels directly affect the balance between plasma atherogenic and antiatherogenic factors, as well as values of the atherogenic index of plasma [AIP (logarithmically transformed ratio of TG-to-HDL-c)]. The aim of this study was to evaluate the AIP risk categories (an indicator of plasma atherogenicity) and the relationships of AIP with other atherosclerosis-related lipid parameters in patients with type 2 diabetes mellitus (T2DM) and their potential clinical utility. Methods: Standard lipid profile, AIP, and lipid hydroperoxides (LOOH) were investigated in 124 T2DM outpatients (mean age 52.7 ± 5.9 years) and 61 healthy subjects (mean age 50.9 ± 6.8 years). T2DM patients were subclassified according to the AIP risk category and glycemic control. Results: Higher levels of AIP, LOOH, and TG and lower HDL-c (all P < 0.0001) were observed in T2DM patients than in the control group. AIP positively correlated with LOOH, non-HDL-c, and the non-HDL/HDL ratio (all P < 0.0001). The TG level was strongly correlated with the LOOH level among T2DM patients (P < 0.0001). Conclusions: The close association of AIP with other atherosclerosis-related lipid factors reveals an increased plasma atherogenicity. AIP risk categories indicate the actual status of plasma atherogenicity and identify subjects who are at an increased atherogenic risk and the development of CVD. In this respect, AIP has a promising future in routine clinical practice.

Prognostic impact of the atherogenic index of plasma in type 2 diabetes mellitus patients with acute coronary syndrome undergoing percutaneous coronary intervention

Background

The association of the atherogenic index of plasma (AIP), an emerging lipid index that can predict the risk for cardiovascular disease, with adverse outcomes in type 2 diabetes mellitus (T2DM) patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) has not been determined. Therefore, the aim of this study was to investigate whether the AIP could independently predict adverse cardiovascular events in T2DM patients with ACS undergoing PCI.

Methods

This study was a retrospective analysis of a single-centre prospective registry involving 826 consecutive T2DM patients who underwent primary or elective PCI for ACS from June 2016 to November 2017. This study ultimately included 798 patients (age, 61 ± 10 years; male, 72.7%). The AIP was calculated as the base 10 logarithm of the ratio of the plasma concentration of triglycerides to high-density lipoprotein-cholesterol (HDL-C). All the patients were divided into 4 groups based on the AIP quartiles. The primary endpoint was a composite of death from any cause, non-fatal spontaneous myocardial infarction (MI), non-fatal ischaemic stroke, and unplanned repeat revascularization. The key secondary endpoint was a composite of cardiovascular death, non-fatal MI, and non-fatal ischaemic stroke.

Results

During a median follow-up period of 927 days, 198 patients developed at least one event. An unadjusted Kaplan-Meier analysis showed that the incidence of the primary endpoint increased gradually with rising AIP quartiles (log-rank test, P = 0.001). A multivariate Cox proportional hazards analysis revealed that compared with the lowest AIP quartile, the top AIP quartile was associated with significantly increased risk for the primary and key secondary endpoints (hazard ratio [HR]: 2.249, 95% confidence interval [CI]: 1.438 to 3.517, P < 0.001; and HR: 2.571, 95% CI: 1.027 to 6.440, P = 0.044, respectively).

Conclusions

A higher AIP value on admission was independently and strongly associated with adverse cardiovascular events in T2DM patients with ACS undergoing PCI.