The atherogenic index of plasma and the risk of mortality in incident dialysis patients: Results from a nationwide prospective cohort in Korea

Mi Jung Lee, Jung Tak Park, SeungHyeok Han, Yong Lim Kim, Yon Su Kim, Chul Woo Yang, Nam Ho Kim, Shin-Wook Kang, Hyung Jong Kim, TaeHyun Yoo

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background The atherogenic index of plasma (AIP), which is the logarithmic ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C), had a linear relationship with clinical outcomes in the general population. However, the association of each lipid profile, TG and HDL-C, with survival was not straightforward in dialysis patients. This non-linear association led us to further investigate the prognostic impact of the AIP in these patients. Methods From a nationwide prospective cohort, 1,174 incident dialysis patients were included. Patients were categorized into quintiles according to the AIP. An independent association of the AIP with all-cause and cardiovascular mortality was determined. Results During a mean follow-up duration of 33.2 months, 170 patients (14.5%) died, and cardiovascular death was observed in 55 patients (4.7%). Multivariate Cox analyses revealed that the lowest (quintile 1, hazard ratio [HR] = 1.76, 95% confidence interval [CI] = 1.02-3.03) and the highest (quintile 5, HR = 2.15, 95% CI = 1.26-3.65) AIP groups were significantly associated with higher all-cause mortality compared to patients in quintile 3 (reference group). In terms of cardiovascular mortality, only the highest AIP group (quintile 5, HR = 2.59, 95% CI = 1.06-6.34) was significantly associated with increased risk of mortality. Sensitivity analyses showed that a U-shaped association between the AIP and all-cause mortality remained significant in non-diabetic and underweight to normal body mass index patients. Conclusions Both the highest and the lowest AIP groups were independently associated with all-cause mortality, showing a U-shaped association. It suggested further studies are needed to identify targets and subgroups that can benefit from intervention of the AIP in incident dialysis patients.

Original languageEnglish
Article numbere0177499
JournalPloS one
Volume12
Issue number5
DOIs
Publication statusPublished - 2017 May 1

Fingerprint

Dialysis
Korea
dialysis
Korean Peninsula
Plasmas
Mortality
confidence interval
Hazards
Confidence Intervals
high density lipoprotein cholesterol
HDL Cholesterol
Triglycerides
triacylglycerols
underweight
Thinness
body mass index
Body Mass Index
Multivariate Analysis
death
Lipids

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Lee, Mi Jung ; Park, Jung Tak ; Han, SeungHyeok ; Kim, Yong Lim ; Kim, Yon Su ; Yang, Chul Woo ; Kim, Nam Ho ; Kang, Shin-Wook ; Kim, Hyung Jong ; Yoo, TaeHyun. / The atherogenic index of plasma and the risk of mortality in incident dialysis patients : Results from a nationwide prospective cohort in Korea. In: PloS one. 2017 ; Vol. 12, No. 5.
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abstract = "Background The atherogenic index of plasma (AIP), which is the logarithmic ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C), had a linear relationship with clinical outcomes in the general population. However, the association of each lipid profile, TG and HDL-C, with survival was not straightforward in dialysis patients. This non-linear association led us to further investigate the prognostic impact of the AIP in these patients. Methods From a nationwide prospective cohort, 1,174 incident dialysis patients were included. Patients were categorized into quintiles according to the AIP. An independent association of the AIP with all-cause and cardiovascular mortality was determined. Results During a mean follow-up duration of 33.2 months, 170 patients (14.5{\%}) died, and cardiovascular death was observed in 55 patients (4.7{\%}). Multivariate Cox analyses revealed that the lowest (quintile 1, hazard ratio [HR] = 1.76, 95{\%} confidence interval [CI] = 1.02-3.03) and the highest (quintile 5, HR = 2.15, 95{\%} CI = 1.26-3.65) AIP groups were significantly associated with higher all-cause mortality compared to patients in quintile 3 (reference group). In terms of cardiovascular mortality, only the highest AIP group (quintile 5, HR = 2.59, 95{\%} CI = 1.06-6.34) was significantly associated with increased risk of mortality. Sensitivity analyses showed that a U-shaped association between the AIP and all-cause mortality remained significant in non-diabetic and underweight to normal body mass index patients. Conclusions Both the highest and the lowest AIP groups were independently associated with all-cause mortality, showing a U-shaped association. It suggested further studies are needed to identify targets and subgroups that can benefit from intervention of the AIP in incident dialysis patients.",
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The atherogenic index of plasma and the risk of mortality in incident dialysis patients : Results from a nationwide prospective cohort in Korea. / Lee, Mi Jung; Park, Jung Tak; Han, SeungHyeok; Kim, Yong Lim; Kim, Yon Su; Yang, Chul Woo; Kim, Nam Ho; Kang, Shin-Wook; Kim, Hyung Jong; Yoo, TaeHyun.

In: PloS one, Vol. 12, No. 5, e0177499, 01.05.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The atherogenic index of plasma and the risk of mortality in incident dialysis patients

T2 - Results from a nationwide prospective cohort in Korea

AU - Lee, Mi Jung

AU - Park, Jung Tak

AU - Han, SeungHyeok

AU - Kim, Yong Lim

AU - Kim, Yon Su

AU - Yang, Chul Woo

AU - Kim, Nam Ho

AU - Kang, Shin-Wook

AU - Kim, Hyung Jong

AU - Yoo, TaeHyun

PY - 2017/5/1

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N2 - Background The atherogenic index of plasma (AIP), which is the logarithmic ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C), had a linear relationship with clinical outcomes in the general population. However, the association of each lipid profile, TG and HDL-C, with survival was not straightforward in dialysis patients. This non-linear association led us to further investigate the prognostic impact of the AIP in these patients. Methods From a nationwide prospective cohort, 1,174 incident dialysis patients were included. Patients were categorized into quintiles according to the AIP. An independent association of the AIP with all-cause and cardiovascular mortality was determined. Results During a mean follow-up duration of 33.2 months, 170 patients (14.5%) died, and cardiovascular death was observed in 55 patients (4.7%). Multivariate Cox analyses revealed that the lowest (quintile 1, hazard ratio [HR] = 1.76, 95% confidence interval [CI] = 1.02-3.03) and the highest (quintile 5, HR = 2.15, 95% CI = 1.26-3.65) AIP groups were significantly associated with higher all-cause mortality compared to patients in quintile 3 (reference group). In terms of cardiovascular mortality, only the highest AIP group (quintile 5, HR = 2.59, 95% CI = 1.06-6.34) was significantly associated with increased risk of mortality. Sensitivity analyses showed that a U-shaped association between the AIP and all-cause mortality remained significant in non-diabetic and underweight to normal body mass index patients. Conclusions Both the highest and the lowest AIP groups were independently associated with all-cause mortality, showing a U-shaped association. It suggested further studies are needed to identify targets and subgroups that can benefit from intervention of the AIP in incident dialysis patients.

AB - Background The atherogenic index of plasma (AIP), which is the logarithmic ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C), had a linear relationship with clinical outcomes in the general population. However, the association of each lipid profile, TG and HDL-C, with survival was not straightforward in dialysis patients. This non-linear association led us to further investigate the prognostic impact of the AIP in these patients. Methods From a nationwide prospective cohort, 1,174 incident dialysis patients were included. Patients were categorized into quintiles according to the AIP. An independent association of the AIP with all-cause and cardiovascular mortality was determined. Results During a mean follow-up duration of 33.2 months, 170 patients (14.5%) died, and cardiovascular death was observed in 55 patients (4.7%). Multivariate Cox analyses revealed that the lowest (quintile 1, hazard ratio [HR] = 1.76, 95% confidence interval [CI] = 1.02-3.03) and the highest (quintile 5, HR = 2.15, 95% CI = 1.26-3.65) AIP groups were significantly associated with higher all-cause mortality compared to patients in quintile 3 (reference group). In terms of cardiovascular mortality, only the highest AIP group (quintile 5, HR = 2.59, 95% CI = 1.06-6.34) was significantly associated with increased risk of mortality. Sensitivity analyses showed that a U-shaped association between the AIP and all-cause mortality remained significant in non-diabetic and underweight to normal body mass index patients. Conclusions Both the highest and the lowest AIP groups were independently associated with all-cause mortality, showing a U-shaped association. It suggested further studies are needed to identify targets and subgroups that can benefit from intervention of the AIP in incident dialysis patients.

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