Association between Serum atherogenic index and cardiovascular diseases and mortality in early adulthood (18-44 years old): Kailuan Longitudinal Cohort Study

BACKGROUNDThe atherogenic index of plasma (AIP), calculated as log (triglycerides / high-density lipoprotein cholesterol), has emerged as a novel marker for assessing atherogenic risk and cardiometabolic health. However, the relationship between AIP and the risks of cardiovascular diseases (CVD) and all-cause mortality in early adulthood remains unclear. In the present study, we investigated the association of AIP with CVD and all-cause mortality in a large-scale cohort. METHODSA total of 41,828 participants aged 18 to 44 years without pre-existing CVD at baseline were enrolled from surveys during 2006 to 2016, and were categorized according to AIP quartiles. All participants were followed biennially through December 31, 2022. To assess the associations between AIP and the incidence of CVD, stroke, and all-cause mortality, both univariate and multivariate Cox proportional hazards regression models were used. Additionally, Kaplan-Meier analysis was conducted to compare cumulative incidence of CVD and stroke across AIP quartiles. RESULTSDuring an average follow-up of 12.65{+/-}3.59 years, a total of 1,113 cases of CVD, 953 cases of stroke, and 969 cases of all-cause mortality were identified. After adjustment for conventional cardiovascular risk factors, including age, gender, smoking status, alcohol consumption, heart rate, hypertension history, triglycerides, total cholesterol, fasting blood glucose, and estimated glomerular filtration rate, the multivariate-adjusted hazard ratios (HRs) and their 95% confidence intervals (CIs) for CVD and stroke, compared to the first quartile (Q1), were as follows: 1.21 (0.99-1.48) and 1.16 (0.94-1.43) in the second quartile group (Q2); 1.44 (1.19-1.74) and 1.28 (1.05-1.58) in the third quartile group (Q3); and 1.40 (1.12-1.75) and 1.28 (1.01-1.63) in the fourth quartile group (Q4). No significant association was observed between AIP and all-cause mortality. ConclusionsOur study found that an elevated AIP is associated with an increased risk of CVD and stroke in young adults. These findings highlight that AIP may serve as a potential risk stratification factor in young populations.