{"title":"Atherogenic index of plasma as a novel predictor for acute kidney injury and disease severity in acute pancreatitis: a retrospective cohort study.","authors":"Wen Wu, Yiming Li, Yupei Zhang, Xing Chen, Chunzhen Zhang, Xingguang Qu, Zhaohui Zhang, Rong Zhang, Zhiyong Peng","doi":"10.1186/s12944-025-02520-x","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The atherogenic index of plasma (AIP) can be used to reveal atherosclerosis. This study evaluated the AIP's efficacy in predicting the prognosis of acute kidney injury (AKI) and severity of acute pancreatitis (AP).</p><p><strong>Methods: </strong>This retrospective cohort study recruited AP cases from the First College of Clinical Medical Science of China Three Gorges University between January 2019 and October 2023, including 1470 patients. AIP was computed using the formula: log10 [serum triglyceride (mmol/L)/serum high-density lipoprotein cholesterol (mmol/L)]. The AIP relationships with AKI occurrence and AP severity were validated using multivariable logistic regression models, subgroup and sensitivity analyses, and curve fitting.</p><p><strong>Results: </strong>Among the 1470 patients with AP, 250 (17%) developed AKI and 166 (11.3%) with severe AP. AIP was positively correlated with AKI and the severity of AP. Potential confounders were adjusted, consequently, AIP was positively linearly related to AKI (P for non-linearity: 0.731, OR 2.5, 95% CI 1.31-4.77,) and the severity of AP (P for non-linearity: 0.145, OR 3.1, 95% CI 1.53-6.27), respectively. The strength of the association between AIP and AKI, along with the severity of AP, was demonstrated through stratified analyses. Significant interactions were not observed in sex, age, hypertension, BMI, diabetes mellitus, SOFA score, BISAP score, and etiology of AP (all P for interaction > 0.05). The areas under the curves for AIP in predicting the incidence of AKI and severity of AP were 0.64 and 0.65, respectively.</p><p><strong>Conclusions: </strong>This is the first study to suggest that the AIP is critical for the assessment of AKI risk, recommending early screening of severity among AP cases. Due to the observational nature of the study, the potential for residual confounding, and the need for external validation in larger, independent cohorts.</p>","PeriodicalId":18073,"journal":{"name":"Lipids in Health and Disease","volume":"24 1","pages":"111"},"PeriodicalIF":3.9000,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934589/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Lipids in Health and Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12944-025-02520-x","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"BIOCHEMISTRY & MOLECULAR BIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The atherogenic index of plasma (AIP) can be used to reveal atherosclerosis. This study evaluated the AIP's efficacy in predicting the prognosis of acute kidney injury (AKI) and severity of acute pancreatitis (AP).
Methods: This retrospective cohort study recruited AP cases from the First College of Clinical Medical Science of China Three Gorges University between January 2019 and October 2023, including 1470 patients. AIP was computed using the formula: log10 [serum triglyceride (mmol/L)/serum high-density lipoprotein cholesterol (mmol/L)]. The AIP relationships with AKI occurrence and AP severity were validated using multivariable logistic regression models, subgroup and sensitivity analyses, and curve fitting.
Results: Among the 1470 patients with AP, 250 (17%) developed AKI and 166 (11.3%) with severe AP. AIP was positively correlated with AKI and the severity of AP. Potential confounders were adjusted, consequently, AIP was positively linearly related to AKI (P for non-linearity: 0.731, OR 2.5, 95% CI 1.31-4.77,) and the severity of AP (P for non-linearity: 0.145, OR 3.1, 95% CI 1.53-6.27), respectively. The strength of the association between AIP and AKI, along with the severity of AP, was demonstrated through stratified analyses. Significant interactions were not observed in sex, age, hypertension, BMI, diabetes mellitus, SOFA score, BISAP score, and etiology of AP (all P for interaction > 0.05). The areas under the curves for AIP in predicting the incidence of AKI and severity of AP were 0.64 and 0.65, respectively.
Conclusions: This is the first study to suggest that the AIP is critical for the assessment of AKI risk, recommending early screening of severity among AP cases. Due to the observational nature of the study, the potential for residual confounding, and the need for external validation in larger, independent cohorts.
背景:血浆动脉粥样硬化指数(AIP)可用于显示动脉粥样硬化。本研究评价了AIP在预测急性肾损伤(AKI)预后和急性胰腺炎(AP)严重程度中的作用。方法:本回顾性队列研究招募2019年1月至2023年10月中国三峡大学第一临床医学学院AP病例1470例。AIP计算公式为:log10[血清甘油三酯(mmol/L)/血清高密度脂蛋白胆固醇(mmol/L)]。采用多变量logistic回归模型、亚组分析、敏感性分析和曲线拟合验证AIP与AKI发生率和AP严重程度的关系。结果:在1470例AP患者中,250例(17%)发展为AKI, 166例(11.3%)为重度AP。AIP与AKI和AP严重程度呈正相关。校正潜在混杂因素后,AIP与AKI(非线性P: 0.731, OR 2.5, 95% CI 1.31-4.77)和AP严重程度(非线性P: 0.145, OR 3.1, 95% CI 1.53-6.27)分别呈线性正相关。通过分层分析证明了AIP和AKI之间的关联强度以及AP的严重程度。性别、年龄、高血压、BMI、糖尿病、SOFA评分、BISAP评分、AP病因无显著交互作用(交互作用P均为0.05)。AIP预测AKI发生率和AP严重程度的曲线下面积分别为0.64和0.65。结论:这是第一个表明AIP对AKI风险评估至关重要的研究,建议在AP病例中早期筛查严重程度。由于该研究的观察性,潜在的残留混淆,以及需要在更大的独立队列中进行外部验证。
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.