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. 2024 Jan 11;23(1):11.
doi: 10.1186/s12944-024-02003-5.

Impact of baseline and trajectory of the atherogenic index of plasma on incident diabetic kidney disease and retinopathy in participants with type 2 diabetes: a longitudinal cohort study

Jia Zhang #  1   2 , Cong Liu #  1   2 , Ying Peng #  1   2 , Qianhua Fang  1   2 , Xing Wei  1   2 , Cui Zhang  1   2 , Lin Sun  1   2 , Zhuomeng Hu  1   2 , Jie Hong  1   2 , Weiqiong Gu  1   2 , Weiqing Wang  1   2 , Juan Shi  3   4 , Yifei Zhang  5   6
Affiliations

Impact of baseline and trajectory of the atherogenic index of plasma on incident diabetic kidney disease and retinopathy in participants with type 2 diabetes: a longitudinal cohort study

Jia Zhang et al. Lipids Health Dis. .

Abstract

Background: Some studies have assessed the predictive role of the atherogenic index of plasma (AIP) for macrovascular diseases. This prospective investigation aimed to elucidate whether AIP is associated with diabetic kidney disease (DKD) and diabetic retinopathy (DR) incidence.

Methods: The data were extracted from 4831 participants, of whom 2943 and 3360 participants with type 2 diabetes (T2D) were included in the DKD and DR follow-up analyses, respectively. Cox regression models were performed to test the relationships of AIP value at baseline with the risk of incident DKD and DR. Group-based trajectory modelling was utilized to discern AIP trajectories during the follow-up period. Subsequently, logistic regressions were applied to ascertain the influence of AIP trajectories on the incidence of DKD and DR.

Results: During the follow-up period, 709 (24.1%) and 193 (5.7%) participants developed DKD and DR, respectively. The median (interquartile range) follow-up time was 24.2 (26.3) months for DKD and 25.7 (27.0) months for DR. According to the multivariate Cox regression models, baseline AIP was positively and linearly related to the occurrence of DKD, with a hazard ratio of 1.75 (95% confidence interval [CI] 1.36-2.26). Three distinct trajectories of AIP were identified throughout the follow-up time: Low (31.4%), Median (50.2%), and High (18.3%). Compared to participants with the Low AIP trajectory, those with High and Median AIP trajectories presented 117% (95% CI: 1.62-2.91) and 84% (95% CI 1.46-2.32) greater odds of developing DKD, respectively. However, neither baseline levels nor trajectories of AIP were shown to be related to DR after adjusting for confounding factors.

Conclusions: Baseline levels and trajectories of AIP were independently related to elevated DKD risk, indicating that AIP could be used as a predictor for identifying T2D participants at higher risk of DKD. No association between AIP and DR was detected.

Keywords: Atherogenic index of plasma; Diabetic kidney disease; Diabetic retinopathy; Lipid profile; Trajectory; Type 2 diabetes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Restricted cubic spline regression for baseline AIP levels and DKD. Adjusted for age, sex, HbA1c, duration of diabetes, BMI, SBP, ideal smoking, drinking, and LDL-C. The solid line indicates the smoothed fitted relationship and the red shaded area represents 95% CI. Abbreviations: AIP atherogenic index of plasma, DKD diabetic kidney disease, CI confidence interval
Fig. 2
Fig. 2
Trajectories of AIP during follow-up visits in the DKD (A) and DR (B) longitudinal analysis datasets. DR refers to referable DR. Abbreviations: AIP atherogenic index of plasma, DKD diabetic kidney disease, DR diabetic retinopathy
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