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 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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Article Info
Publication History
Published online: April 28, 2022
Accepted:
April 24,
2022
Received in revised form:
April 12,
2022
Received:
December 11,
2021
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Canadian Diabetes Association.
