The association between the atherogenic index of plasma and all-cause mortality in patients undergoing peritoneal dialysis: a multicenter cohort study.

IF 3.9 2区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY

Lipids in Health and Disease Pub Date : 2025-03-13 DOI:10.1186/s12944-025-02510-z

Yaohua Hu, Liming Yang, Zhanshan Sun, Xiaoxuan Zhang, Xueyan Zhu, Jian Li, Xinyang Li, Mengyuan Yu, Wenpeng Cui

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引用次数: 0

Abstract

Background: The Atherogenic Index of Plasma (AIP) has been reported as a strong predictor of all-cause mortality in the overall population. However, the lipid profile changes in individuals with end-stage kidney disease (ESKD) undergoing peritoneal dialysis (PD) may affect the prognostic utility of AIP for all-cause mortality. The connection between them remains unclear.

Methods: This study included patients receiving PD at five hospitals in China from January 1, 2013, to December 31, 2019, with follow-up until June 30, 2020. The primary exposure variable in this investigation was the logarithm of the triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C) ratio, which was used to compute the AIP, and the outcome variable was all-cause mortality. A Cox proportional hazards regression model was employed to analyze the association between AIP and all-cause mortality. Moreover, stratified analyses were performed to investigate this association further. Kaplan-Meier curves were employed for survival analysis, assessing the prognostic implications of varying AIP levels. Nonlinear associations were examined using smooth curve fitting techniques.

Results: A total of 869 patients were included in this study, of whom 153 died during the follow-up period. An inverse association was observed between AIP and all-cause mortality risk in the highest tertile compared to the lowest tertile (HR: 0.56, 95% CI: 0.37-0.84) after correcting for potential confounding variables. Moreover, a nonlinear association was observed between the rates of all-cause mortality and AIP. A segmented Cox regression model identified an inflection point at an AIP value of 0.63 (P = 0.014 for the log-likelihood ratio test). More specifically, it was negatively associated with the all-cause mortality risk (HR: 0.42, 95% CI: 0.25-0.73, P = 0.002) when AIP was ≤ 0.63. On the other hand, AIP showed a positive association with the risk of all-cause mortality when it was more than 0.63 (HR: 8.94, 95% CI: 1.66-48.10, P = 0.011).

Conclusion: The present study identified a non-linear association between AIP and all-cause mortality in patients receiving peritoneal dialysis.

查看原文本刊更多论文

腹膜透析患者血浆致动脉粥样硬化指数与全因死亡率之间的关系：一项多中心队列研究。

背景：据报道，血浆动脉粥样硬化指数（AIP）是预测人群全因死亡率的重要指标。然而，接受腹膜透析（PD）的终末期肾病（ESKD）患者的脂质谱变化可能会影响AIP对全因死亡率的预后效用。他们之间的联系尚不清楚。方法：本研究纳入2013年1月1日至2019年12月31日在中国五家医院接受PD治疗的患者，随访至2020年6月30日。本研究的主要暴露变量是用于计算AIP的甘油三酯(TG)/高密度脂蛋白胆固醇（HDL-C）比值的对数，结果变量是全因死亡率。采用Cox比例风险回归模型分析AIP与全因死亡率的关系。此外，还进行了分层分析以进一步调查这种关联。Kaplan-Meier曲线用于生存分析，评估不同AIP水平对预后的影响。使用光滑曲线拟合技术检验非线性关联。结果：本研究共纳入869例患者，其中153例在随访期间死亡。在校正了潜在的混杂变量后，观察到AIP与全因死亡风险之间的负相关（HR: 0.56, 95% CI: 0.37-0.84）。此外，观察到全因死亡率与AIP之间存在非线性关联。分段Cox回归模型识别出AIP值为0.63的拐点（对数似然比检验P = 0.014）。更具体地说，当AIP≤0.63时，它与全因死亡风险呈负相关（HR: 0.42, 95% CI: 0.25-0.73, P = 0.002）。另一方面，AIP与全因死亡风险> 0.63时呈正相关（HR: 8.94, 95% CI: 1.66 ~ 48.10, P = 0.011）。结论：本研究确定了接受腹膜透析患者AIP与全因死亡率之间的非线性关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Lipids in Health and Disease 生物-生化与分子生物学

CiteScore

7.70

自引率

2.20%

发文量

122

审稿时长

3-8 weeks

期刊介绍： Lipids in Health and Disease is an open access, peer-reviewed, journal that publishes articles on all aspects of lipids: their biochemistry, pharmacology, toxicology, role in health and disease, and the synthesis of new lipid compounds. Lipids in Health and Disease is aimed at all scientists, health professionals and physicians interested in the area of lipids. Lipids are defined here in their broadest sense, to include: cholesterol, essential fatty acids, saturated fatty acids, phospholipids, inositol lipids, second messenger lipids, enzymes and synthetic machinery that is involved in the metabolism of various lipids in the cells and tissues, and also various aspects of lipid transport, etc. In addition, the journal also publishes research that investigates and defines the role of lipids in various physiological processes, pathology and disease. In particular, the journal aims to bridge the gap between the bench and the clinic by publishing articles that are particularly relevant to human diseases and the role of lipids in the management of various diseases.