To determine the association of atherogenic index of plasma (AIP), the logarithm of molar ratio of triglyceridemia to high-density lipoprotein cholesterol (TG/HDL-cholesterol) with cardiometabolic disorders was investigated in a sample of the Turkish population.
A total of 2676 middle-aged adults were prospectively evaluated with a clinical examination and laboratory tests during 7.8 years' follow-up.
AIP was significantly associated in multiple linear regression analyses with greater apolipoprotein B and lower low-density lipoprotein (LDL)-cholesterol levels, reflecting the presence of smaller LDL particle size. Whereas in men insulin levels, obesity, and nonHDL-cholesterol were major determinants, C-reactive protein (CRP) was the strongest determinant of AIP among women, independent of body mass index. Top quartiles of AIP predicted significantly age-adjusted incident coronary heart disease (CHD) in both sexes, more strongly in women, in whom quartile 3 also was a predictor with a greater than 2-fold relative risk. Associations remained significant after adjustment for CRP and traditional risk factors. AIP significantly predicted diabetes and high blood pressure in both sexes after adjustment for age and CRP. With regard to incident high blood pressure, the risk ratio in men was attenuated when body mass index also was adjusted.
High AIP, a surrogate of small LDL particle size, reflects obesity and hyperinsulinemia in men and high CRP status in women. It predicts CHD independently, type 2 diabetes mediated by obesity in men and in women, high blood pressure, metabolic syndrome, and CHD potentially mediated by involvement in a proinflammatory status reflected by CRP.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Clinical Lipidology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults (Adult Treatment Panel III).JAMA. 2001; 285: 2486-2497
- Fasting triglycerides, high-density lipoprotein and the role of myocardial infarction.Circulation. 1997; 96: 2520-2525
- The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FERHDL).Clin Biochem. 2001; 34: 583-588
- Fractional esterification rate of cholesterol and ratio of triglycerides to HDL-cholesterol are powerful predictors of positive findings on coronary angiography.Clin Chem. 2003; 49: 1873-1880
- Use of metabolic markers to identify overweight individuals who are insulin resistant.Ann Intern Med. 2003; 139: 802-809
- Middle-aged men with increased waist circumference and elevated C-reactive protein level are at higher risk for postoperative atrial fibrillation following coronary artery bypass grafting surgery.Eur Heart J. 2009; 30: 1270-1279
- Risk factors and cardiovascular disease in Turkey.Atherosclerosis. 2001; 156: 1-10
- Metabolic syndrome: major impact on coronary risk in a population with low cholesterol levels—a prospective and cross-sectional evaluation.Atherosclerosis. 2002; 165: 285-292
- Plasma lipids and their interrelation in Turkish adults.J Epidemiol Community Health. 1992; 46: 470-476
- Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Follow-up report on the diagnosis of diabetes mellitus.Diabetes Care. 2003; 26: 3160-3167
- Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition.Circulation. 2004; 109: 433-438
- Determinants and definition of abdominal obesity as related to risk of diabetes, metabolic syndrome and coronary disease in Turkish men: a prospective cohort study.Atherosclerosis. 2007; 191: 182-190
- Predictors of abdominal obesity and high susceptibility of cardiometabolic risk to its increments among Turkish women: a prospective population-based study.Metabolism. 2007; 56: 348-356
- Cardiovascular Survey Methods.2nd ed. WHO, Geneva1982 (124–127)
- Impaired protection against diabetes and coronary disease by high-density lipoproteins in Turks.Metabolism. 2009; 58: 1393-1399
- Accuracy of the ratio of triglyceride to high-density lipoprotein cholesterol for predicting low-density lipoprotein cholesterol particle sizes, phenotype B, and particle concentrations among Asian Indians.Am J Cardiol. 2006; 97: 1007-1009
- Relationship between insulin sensitivity and the triglyceride-HDL-C ratio in overweight and obese postmenopausal women: a MONET study.Appl Physiol Nutr Metab. 2007; 32: 1089-1096
- Fat fuels the flame: triglyceride-rich lipoproteins and arterial inflammation.Circ Res. 2007; 100: 299-301
- Apolipoprotein CIII induces expression of vascular cell adhesion molecule-1 in vascular endothelial cells and increases adhesion of monocytic cells.Circulation. 2006; 114: 681-687
- Triglyceride/HDL-cholesterol ratio is an independent predictor for coronary heart disease in a population of Iranian men.Nutr Metab Cardiovasc Dis. 2009; 19: 401-408
- The triglyceride/high-density lipoprotein cholesterol ratio predicts all-cause mortality in women with suspected myocardial ischemia: a report from the Women's Ischemia Syndrome Evaluation (WISE).Am Heart J. 2009; 157: 548-555
- Normal triglyceride levels and coronary artery disease events: the Baltimore Coronary Observational Long-term Study (COLTS).J Am Coll Cardiol. 1998; 31: 1252-1257
- Acute hypertriglyceridaemia in humans increases the triglyceride content and decreases the anti-inflammatory capacity of high density lipoproteins.Atherosclerosis. 2009; 204: 424-428
- The paradox of high apolipoprotein A-I levels independently predicting incident type-2 diabetes among Turks.Int J Cardiol. 2009; ([In Press])
- Serum apolipoprotein C-III in high-density lipoprotein: a key diabetogenic risk factor among Turks.Diabet Med. 2009; 26: 981-988
Published online: February 15, 2010
Accepted: February 8, 2010
Received: December 28, 2009
© 2010 National Lipid Association. Published by Elsevier Inc. All rights reserved.