Dataset Information

The atherogenic index of plasma: A novel factor more closely related to non-alcoholic fatty liver disease than other lipid parameters in adults.

ABSTRACT:

Background and aims

The relationship of non-alcoholic fatty liver disease (NAFLD) with the atherogenic index of plasma (AIP) is unclear. This study aims to detect the association between AIP and NAFLD, compare the discriminative power of AIP with other lipid parameters for NAFLD, and establish a discriminant model using physical examination data.

Methods

Participants aged over 20 years who underwent routine physical examination in Beijing Chaoyang Hospital from April 2016 to August 2020 were included. We categorized subjects based on hepatic ultrasound results and analyzed the association between NAFLD risk and AIP, conventional plasma lipids, remnant cholesterol (RC), triglyceride and glucose (TyG) index, and other atherogenic indices (n = 112,200) using logistic regression, restricted cubic spline regression, and receiver operating characteristic curve.

Results

Out of the 112,200 subjects, 30.4% had NAFLD. The body weight index, plasma glucose, conventional lipids, TyG index, AIP, atherogenic coefficient (AC), and coronary risk index (CRI) were significantly higher, while HDL-C was lower (p < 0.001) in patients with NAFLD than those without NAFLD (all p < 0.001). Compared with conventional lipids, RC, TyG index, AC, and CRI, AIP had a stronger correlation with the risk of NAFLD (OR 6.71, 95% CI 6.23-7.22, p < 0.001) after adjusting confounders and presented a non-linear dose-response relationship (p < 0.0001). The optimal cut-off value of AIP was 0.05 and the area under the curve (AUC) was 0.82 (95% CI: 0.81-0.82) with high sensitivity and specificity. The AUC of the simplified three-variable NAFLD discriminant model was 0.90 in both the training set and the validation set.

Conclusion

AIP was significantly associated with NAFLD and showed superior discriminative performance to other lipid parameters. These findings might help screen NAFLD in high-risk individuals and reduce the prevalence of NAFLD.

SUBMITTER: Liu J

PROVIDER: S-EPMC9478109 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

The atherogenic index of plasma: A novel factor more closely related to non-alcoholic fatty liver disease than other lipid parameters in adults.

Liu Jia J Zhou Liyuan L An Yu Y Wang Ying Y Wang Guang G

Frontiers in nutrition 20220902

<h4>Background and aims</h4>The relationship of non-alcoholic fatty liver disease (NAFLD) with the atherogenic index of plasma (AIP) is unclear. This study aims to detect the association between AIP and NAFLD, compare the discriminative power of AIP with other lipid parameters for NAFLD, and establish a discriminant model using physical examination data.<h4>Methods</h4>Participants aged over 20 years who underwent routine physical examination in Beijing Chaoyang Hospital from April 2016 to Augus ...[more]

PMID: 36118762

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Project description:IntroductionNon-alcoholic fatty liver disease (NAFLD) in the non-obese population accounts for a large proportion of NAFLD. Atherogenic index of plasma (AIP, defined as the logarithm of the triglyceride/high-density lipoprotein cholesterol ratio.) can provide a stronger reflection of dyslipidemia and studies on the longitudinal association between AIP and NAFLD were limited in non-obese participants, especially in different BMI groups.MethodsWe performed a post-hoc analysis of data obtained from the Dryad data repository (Dryad is a nonprofit open database of medicine.) and explored the predictive value of AIP on the risk of NAFLD among non-obese participants.ResultsThis study included 16173 participants with AIP, of which 2322(14.4%) non-obese participants developed into individuals with NAFLD with the 5-year follow-up examination. The difference between AIP quartiles in the cumulative estimation of new-onset NAFLD was significant, and with increased AIP, the cumulative new-onset NAFLD gradually increased. Participants in higher AIP quartiles had a significantly increased risk of NAFLD. In the fully adjusted model 3, hazard ratios of the new-onset NAFLD for subjects in Q2, Q3, and Q4 of AIP were 2.00 (1.59, 2.53), 2.61 (2.09, 3.72), and 4.49 (3.62, 5.57) respectively. Meanwhile, the trend test for the association between AIP quartiles and the new-onset NAFLD presented that AIP quartile was positively and strongly associated with the new-onset NAFLD (adjusted hazard ratio (95%CI) in Model 3: 1.59 (1.51, 1.67), P<0.001). We found that AIP was also positively and strongly associated with new-onset NAFLD in different sex groups and different age groups in female patients. Moreover, the predictive ability of AIP was no significant difference in different sex groups and different age groups in female patients. In the subgroup analysis, we found that in the low BMI population, the predictive effect of AIP for new-onset NAFLD was expanded by 2-3 times for each quality increase of AIP.ConclusionThis study found that AIP was a strong independent risk factor for new-onset NAFLD among non-obese individuals especially in the low BMI participants, and screening for AIP in this population can be used to prevent future NAFLD.

Project description:The Atherogenic Index of Plasma (AIP), calculated by log (Triglycerides/HDL-C), has been proposed as a marker of atherogenic and cardiovascular risk. Atherosclerosis and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) share some pathogenic features and may be considered clinical manifestations of Metabolic Syndrome. In this study, we aimed to investigate the role of increased AIP as a putative metabolic biomarker for MASLD. 1,496 individuals (49% males and 51% females) underwent clinical examination for Metabolic Syndrome at Internal Medicine Division "C. Frugoni" of University Hospital of Bari, Italy in the period between January 2016 and April 2024. Clinical history was recorded, and physical examination, anthropometric measures, biochemical assessment, and abdomen ultrasound were performed. In the overall population, AIP significantly correlated with fasting glycemia (FPG, r = 0.26, p < 0.0001), HbA1c (r = 0.20, p < 0.0001), LDL (r = 0.11, p < 0.0001) and total cholesterol (r = 0.09; p < 0.0001), and anthropometric measures of obesity BMI (r = 0.37, p < 0.0001) and Waist Circumference (r = 0.44; p < 0.001). We then investigated AIP values in patients with and without dysmetabolic conditions, finding that AIP significantly increased as steatosis worsened (p < 0.001). ROC curves identified an optimal cut-off of 0.31 for accurately diagnosing severe steatosis and AIP values above this cut-off discriminated patients with significantly increased (p < 0.0001) fasting glycemia, LDL, and waist circumference, and were strongly associated (p < 0.0001) with MASLD (LLR 85.3), type 2 diabetes (LLR 85.5), abdominal obesity (LLR 72.9), overweight (LLR 151.8), and systemic obesity (LLR 178.4). The risk for being diagnosed with such conditions was found to be even higher in the subpopulation of patients with severe liver steatosis. To validate our findings, we considered another cohort of patients with and without biopsy-proven liver steatosis (public dataset GSE89632), confirming that a significant increase (p < 0.001) in AIP values could be found in patients with liver steatosis compared to healthy controls. AIP can be considered a specific biomarker of fatty liver disease with high sensitivity for the diagnosis of the severe form of liver steatosis. Considering AIP in the evaluation of patients with liver steatosis may augment the accuracy for diagnosing metabolic impairment and MASLD.

Project description:Background & aimsPopulation screening for non-alcoholic fatty liver disease (NAFLD) and associated comorbidities remains an unaddressed clinical need. We aimed to assess the utility of the fatty liver index (FLI) for risk stratification of NAFLD and related comorbidities using the UK Biobank.MethodsElectronic health records and liver MRI-proton density fat fraction (PDFF) were used to define NAFLD cases. FLI was calculated and individuals with high alcohol intake and other liver diseases were excluded. Using listwise deletion analysis, the area under receiver-operating characteristic curve (AUROC) of FLI for NAFLD risk was determined. Thereafter, time-dependent covariate-adjusted Cox regression models were used to estimate FLI's risk stratification potential for comorbidities of interest.ResultsFLI was derived for 327,800 individuals with a median age of 58 (IQR 51.5-64.5), of whom 59.8% were females. Using Perspectum Diagnostics and AMRA protocols as references, FLI identified the risk of NAFLD with AUROCs (95% CI, n) of 0.858 (0.848-0.867, n = 7,566) and 0.851 (0.844-0.856, n = 10,777), respectively. Intermediate and high-risk FLI was associated with increased cardiometabolic and malignant disease. In the first 3 years, high-risk FLI conferred an increased risk (adjusted hazard ratio, 95% CI) of ischaemic heart disease (2.14, 1.94-2.36), hypertension (2.84, 2.70-2.98), type 2 diabetes mellitus (4.55, 4.04-5.12), dyslipidaemia (2.48, 2.32-2.64), ischaemic stroke (1.31, 1.20-1.42) and hepatic malignancy (1.69, 1.23-2.30). FLI was not associated with risk of extrahepatic malignancy but was associated with a higher risk of specific cancers (colon, upper gastrointestinal and breast). All-cause mortality was similarly stratified by FLI, independently of non-invasive fibrosis scores.ConclusionsFLI identifies NAFLD and holds potential for the risk stratification of cardiometabolic and malignant disease outcomes (including some extrahepatic malignancies), as well as all-cause mortality. Its use in population screening for primary and secondary prevention of NAFLD should be considered.Impact and implicationsOur analysis using the UK Biobank study shows the potential of the fatty liver index as a risk stratification tool for identifying the risk of developing NAFLD, ischaemic heart disease, ischaemic stroke, type 2 diabetes mellitus, hypertension, hyperlipidaemia, hepatic malignancy, specific metabolism-related malignancies and all-cause mortality. These results suggest that the fatty liver index should be considered as a non-invasive steatosis score that may help guide primary prevention strategies for NAFLD and related outcomes.

Dataset Information

The atherogenic index of plasma: A novel factor more closely related to non-alcoholic fatty liver disease than other lipid parameters in adults.

Background and aims

Methods

Results

Conclusion

Publications

The atherogenic index of plasma: A novel factor more closely related to non-alcoholic fatty liver disease than other lipid parameters in adults.

Similar Datasets

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