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Background <p>Abnormal lipid metabolism is a well-established risk factor for insulin resistance. However, the effect of the atherogenic index of plasma (AIP) on diabetes or impaired fasting glucose (IFG) has been rarely explored, particularly in large-scale, multicenter studies. Therefore, this study aims to assess the effect of AIP on diabetes or IFG in a large cohort of the Chinese population.</p> Methods <p>This multicenter cohort study encompassed 100,876 normoglycemic subjects in China. The effect of AIP on diabetes or IFG was analyzed using a Cox proportional hazards regression analysis. Nonlinear associations were examined using restricted cubic spline models. The use of time-dependent ROC analysis serves to evaluate the predictive performance of glycemic status over a time frame of 3, 4, and 5 years.</p> Results <p>During an average follow-up of 3.12 years, 13,090 participants (12.98%) developed diabetes or IFG. Multivariate analysis revealed that heightened AIP independently predicted an elevated risk of diabetes or IFG development (HR: 1.25, 95% CI: 1.17–1.34, <i>P</i> &lt; 0.0001). Further analysis uncovered a nonlinear correlation between AIP and diabetes or IFG. Specifically, a significant positive association was identified when AIP was below 0.03 (HR: 1.74; 95%CI: 1.53–1.98, <i>P</i> &lt; 0.0001). Conversely, for AIP values above 0.03, the association was no longer statistically significant (HR: 0.91, 95% CI: 0.81–1.04, <i>P</i> = 0.1582). Furthermore, the AIP demonstrates a non-linear relationship with both diabetes and IFG. The time-dependent ROC analysis reveals that the AUC for diabetes risk increases from 0.5931 at 3 years to 0.6795 at 5 years, while the AUC for IFG risk shows a slight increase from 0.5931 at 3 years to 0.6036 at 5 years, and the AUC for diabetes or IFG risk rises from 0.5966 at 3 years to 0.6102 at 5 years.</p> Conclusion <p>AIP levels demonstrated a positive, nonlinear correlation with diabetes or IFG risk. These findings substantiate the utility of AIP as a predictive marker for future glycemic status. The clinical application of AIP might provide a novel approach for long-term monitoring and intervention in hyperglycemia prevention.</p>

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Association between the atherogenic index of plasma and the risk of diabetes or impaired fasting glucose: A Five-Year cohort study in a Chinese population

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  • 发表日期：

    2026年2月3日

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  • Tingting Zhang,
  • Mingxing Lou,
  • Xinglou Li,
  • Yuchang Wang,
  • Peichun Li

摘要

Background

Abnormal lipid metabolism is a well-established risk factor for insulin resistance. However, the effect of the atherogenic index of plasma (AIP) on diabetes or impaired fasting glucose (IFG) has been rarely explored, particularly in large-scale, multicenter studies. Therefore, this study aims to assess the effect of AIP on diabetes or IFG in a large cohort of the Chinese population.

Methods

This multicenter cohort study encompassed 100,876 normoglycemic subjects in China. The effect of AIP on diabetes or IFG was analyzed using a Cox proportional hazards regression analysis. Nonlinear associations were examined using restricted cubic spline models. The use of time-dependent ROC analysis serves to evaluate the predictive performance of glycemic status over a time frame of 3, 4, and 5 years.

Results

During an average follow-up of 3.12 years, 13,090 participants (12.98%) developed diabetes or IFG. Multivariate analysis revealed that heightened AIP independently predicted an elevated risk of diabetes or IFG development (HR: 1.25, 95% CI: 1.17–1.34, P < 0.0001). Further analysis uncovered a nonlinear correlation between AIP and diabetes or IFG. Specifically, a significant positive association was identified when AIP was below 0.03 (HR: 1.74; 95%CI: 1.53–1.98, P < 0.0001). Conversely, for AIP values above 0.03, the association was no longer statistically significant (HR: 0.91, 95% CI: 0.81–1.04, P = 0.1582). Furthermore, the AIP demonstrates a non-linear relationship with both diabetes and IFG. The time-dependent ROC analysis reveals that the AUC for diabetes risk increases from 0.5931 at 3 years to 0.6795 at 5 years, while the AUC for IFG risk shows a slight increase from 0.5931 at 3 years to 0.6036 at 5 years, and the AUC for diabetes or IFG risk rises from 0.5966 at 3 years to 0.6102 at 5 years.

Conclusion

AIP levels demonstrated a positive, nonlinear correlation with diabetes or IFG risk. These findings substantiate the utility of AIP as a predictive marker for future glycemic status. The clinical application of AIP might provide a novel approach for long-term monitoring and intervention in hyperglycemia prevention.