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Association of Atherogenic Index of Plasma With Retinopathy and Nephropathy in Adult Patients With Type 2 Diabetes Mellitus Aged >18 Years

  • Jinling Xu
    Affiliations
    The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China

    Department of Endocrinology, General Hospital of Central Theater Command, Wuhan, Hubei, China
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  • Hui Zhou
    Affiliations
    Department of General Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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  • Guangda Xiang
    Correspondence
    Address for correspondence: Guangda Xiang MD, Department of Endocrinology, General Hospital of Central Theater Command, Wuluo Road 627, Wuhan 430070, Hubei Province, China.
    Affiliations
    The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China

    Department of Endocrinology, General Hospital of Central Theater Command, Wuhan, Hubei, China
    Search for articles by this author
Published:April 28, 2022DOI:https://doi.org/10.1016/j.jcjd.2022.04.008

      Abstract

      Objectives

      In this study, we assessed the atherogenic index of plasma (AIP) in relation to retinopathy and nephropathy in patients with type 2 diabetes mellitus (T2DM).

      Methods

      In this cross-sectional study, there were 4,358 inpatients with T2DM. The patients were divided into 4 groups: T2DM without complications (DM group), T2DM complicated with retinopathy alone and nephropathy alone (DR-alone and DN-alone groups) and T2DM complicated with both DR and DN (DRN group). AIP was calculated by the formula of log (triglyceride/high-density lipoprotein cholesterol).

      Results

      AIPs in the DR-alone, DN-alone and DRN groups were significantly higher than those in the DM group, with the DRN group having the highest AIP level. Moreover, patients with proliferative DR had higher AIPs than patients with nonproliferative DR in the DR-alone and DRN groups, and patients with macroalbuminuria had higher AIPs than patients with microalbuminuria in DN-alone and DRN groups. The highest AIP quartile group had the highest proportion of DRN compared with the other quartile groups. The DRN group had a maximal area under the curve (AUC) for AIP on receiver operating characteristic curve analysis (AUC=0.735). In the subgroup analyses by age, the AUCs of patients <65 years of age were all greater than those of patients ≥65 years of age. Logistic regression analysis showed that AIP had the highest correlation with age <65 years in individuals with DRN, and this association remained significant after adjustment with 3 models.

      Conclusions

      AIP is positively associated with both occurrence and severity of diabetic microvascular complications. It can predict their presence in T2DM, especially in those <65 years of age with DRN.

      Résumé

      Objectifs

      Dans la présente étude, nous avons évalué l’indice d’athérogénicité plasmatique (IAP) par rapport à la rétinopathie et à la néphropathie chez les patients atteints du diabète sucré de type 2 (DST2).

      Méthodes

      Cette étude transversale comptait 4358 patients hospitalisés atteints du DST2. Nous avons réparti les patients en 4 groupes : le DST2 sans complications (groupe DS), le DST2 dont la seule complication est la rétinopathie ou la néphropathie (groupes RD-seule et ND-seule) et le DST2 dont les complications sont la rétinopathie et la néphropathie (groupe RND). Nous avons calculé l’IAP à l’aide de la formule logarithmique [triglycérides/cholestérol à lipoprotéines de haute densité].

      Résultats

      Les IAP des groupes RD-seule, ND-seule et RND étaient significativement plus élevés que celui du groupe DS, et le groupe RND avait le taux d’IAP le plus élevé. De plus, les patients atteints de RD proliférante avaient des IAP plus élevés que les patients atteints de RD non proliférante dans les groupes RD-seule et RND, et les patients qui avaient une macroalbuminurie avaient des IAP plus élevés que les patients qui avaient une microalbuminurie dans les groupes ND-seule et RND. Le groupe dans le quartile de l’IAP le plus élevé avait une plus forte proportion de RND que les groupes des autres quartiles. Le groupe RND avait une surface maximale sous la courbe (SSC) de l’IAP à l’analyse des courbes ROC (de l’anglais, receiver operating characteristic) (SSC = 0,735). Dans les analyses en sous-groupes par âge, les SSC des patients < 65 ans étaient toutes plus grandes que celles des patients ≥ 65 ans. L’analyse de régression logistique a montré que l’IAP obtenait la plus forte corrélation chez les individus atteints de RND < 65 ans, et cette association est restée significative après l’ajustement aux 3 modèles.

      Conclusions

      Les IAP étaient positivement associés à la fréquence et à la gravité des complications microvasculaires du diabète. Ils peuvent permettre de prédire leur présence lors de DST2, particulièrement chez les patients atteints de RND < 65 ans.

      Keywords

      Mots clés

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