Abstract
BACKGROUND: Atherogenic index of plasma (AIP) at baseline has been associated with increased morbidity and mortality from cardiovascular disease (CVD). However, the relationship between long-term AIP trajectories and CVD remains unclear. Therefore, this study aimed to investigate the associations between AIP trajectories and the incidence of CVD in the English population. METHOD: The study data analysis was based on the English Longitudinal Study of Aging (ELSA) from 2004 to 2017. The study population consisted of individuals aged 50 years and older in England. AIP was calculated as log(10) (triglycerides/high-density lipoprotein cholesterol). Group-based trajectory model (GBTM) was applied to identify the trajectory of the AIP index from Wave 2 to 8 over a 12-year follow-up. Cox proportional hazard models were then used to analyze the associations between different AIP index trajectory groups and the incidence of CVD. RESULTS: A total of 3976 participants with completed AIP data in Wave 2 and more than two AIP measurements between Wave 2 and Wave 8 were enrolled in the ELSA cohort. The participants were divided into three groups [low-stable group (n = 1146), moderate-stable group (n = 2110), high-stable group (n = 720)] using a GBTM model. After adjusting for potential confounders, participants in the high-stable group indicated an increased risk of developing incident of CVD compared to those in the low-stable AIP group [Hazard Ratio (HR) 1.33; 95% Confidence Interval (CI) 1.02-1.74, P = 0.033]. However, no differences in the incidence of CVD (HR 1.20, 95%CI 0.98-1.48, P = 0.082) were observed in the moderate-stable group. Subgroup analysis indicated similar results for participants under 63 years old and those with high alcohol consumption. CONCLUSIONS: A high and sustainable level of the AIP index may contribute to the incidence of CVD. The trajectories of the AIP index can help identify older English individuals at increased risk of CVD who deserve primitive preventive and therapeutic approaches.