AIP, fatty liver, and HbA1c as modifiers of the C-index and diabetes risk relationship.

IF 3.9 2区医学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Lipids in Health and Disease Pub Date : 2025-04-02 DOI:10.1186/s12944-025-02546-1

Yanmei Liu, Rui Shi, Huiying Cao, Jian Zhang, Shuangyue Li, Xilin Kang, Yongjuan Ma, Yudian Wu, Yangfan Guo, Lei Feng

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Abstract

Background and aims: Recent studies have suggested an interplay between conicity index (C-index)-related diabetes risk and lipid burden. It is plausible that the atherogenic index of plasma (AIP), fatty liver, and HbA1c mediate the association between C-index and diabetes risk, though this has not been fully explored. This study explored whether AIP, fatty liver, and HbA1c mediate the relationship between C-index and diabetes risk, as well as their combined effect.

Methods: Data from 15,453 participants in the NAGALA Cohort were analyzed (median follow-up 5.39 years). Restricted Cubic Spline (RCS) and univariate Cox regression models adjusted for risk factors were used to assess the role of AIP in modifying the C-index-diabetes relationship. Mediation analysis assessed the contributing factors, and predictive models for diabetes were established.

Results: Among normoglycemic individuals, the AIP and C-index remained significantly and positively associated with diabetes risk. Higher AIP levels strengthened the C-index-diabetes association, particularly in the AIP range of 0.11-≤1.21. In the initial model, hazard ratios (HRs) for those in the fourth quartile of the C-index distribution in this group showed a significant HR of 2.22 (1.37-3.59). As fatty liver and HbA1c levels were progressively adjusted, the HRs gradually decreased, but a significant HR of 1.70 (1.05-2.76) was retained in the fully adjusted model. No significant association was observed in the other AIP strata. Furthermore, AIP, fatty liver, and HbA1c mediated the relationship between C-index and diabetes risk, with mediation effects of 9.8%, 25.0%, and 13.4%, respectively. Notably, the combined model incorporating AIP, fatty liver, HbA1c, and the C-index achieved the highest predictive performance (AUC = 0.86), outperforming the C-index alone (AUC = 0.68).

Conclusions: C-index was significantly associated with diabetes risk, modified by AIP, fatty liver, and HbA1c. These findings emphas ize the importance of AIP along with the C-index, particularly in the context of fatty liver and HbA1c, for diabetes risk screening and management.

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AIP、脂肪肝和HbA1c作为c指数与糖尿病风险关系的调节因子。

背景和目的：最近的研究表明，锥度指数（C-index）相关的糖尿病风险与脂质负担之间存在相互作用。血浆粥样硬化指数（AIP）、脂肪肝和HbA1c介导c指数与糖尿病风险之间的关联似乎是合理的，尽管这还没有得到充分的探讨。本研究探讨AIP、脂肪肝、HbA1c是否介导c指数与糖尿病风险的关系，以及三者的联合作用。方法：分析来自NAGALA队列的15,453名参与者的数据（中位随访5.39年）。使用限制三次样条（RCS）和校正危险因素的单变量Cox回归模型来评估AIP在改变c指数与糖尿病关系中的作用。中介分析评估影响因素，建立糖尿病预测模型。结果：在血糖正常的个体中，AIP和c指数与糖尿病风险保持显著正相关。较高的AIP水平加强了c指数与糖尿病的相关性，特别是在AIP 0.11-≤1.21范围内。在初始模型中，该组c指数分布的第四个四分位数的风险比（HR）为2.22（1.37-3.59）。随着脂肪肝和HbA1c水平的逐步调整，HR逐渐降低，但在完全调整模型中HR保持在1.70（1.05-2.76）。在其他AIP地层中未观察到显著关联。AIP、脂肪肝和HbA1c介导了c -指数与糖尿病风险的关系，其中介效应分别为9.8%、25.0%和13.4%。值得注意的是，AIP、脂肪肝、HbA1c和C-index联合模型的预测性能最高（AUC = 0.86），优于单独的C-index （AUC = 0.68）。结论：c -指数与糖尿病风险显著相关，并受AIP、脂肪肝和HbA1c的影响。这些发现强调了AIP和c指数对于糖尿病风险筛查和管理的重要性，特别是在脂肪肝和HbA1c的背景下。

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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.