Association between atherogenic index of plasma and incident aortic disease: a population-based prospective analysis.

To clarify whether atherogenic index of plasma (AIP), a comprehensive indicator reflecting both the protective and atherogenic effects of lipoproteins on cardiometabolic health, is associated with increased risk of aortic disease. Large-scale, population-based, observational, prospective cohort study. Health dataset from UK Biobank. A total of 17 530 participants, aged 40-70 years, were enrolled and completed the initial assessment visit before 2010. Participants with a history of aortic dissection (AD) or aortic aneurysm (AA), baseline connective tissue disease, missing triglyceride and high-density lipoprotein cholesterol values, fasting time less than 8 hours or those lost to follow-up were excluded. Aortic disease, a composite outcome comprising AD and AA. During a median follow-up period of 15.1 years, 164 aortic disease cases, including 14 AD and 155 AA cases, were documented. A linear trend between AIP and the risk of incident aortic disease was confirmed (p for non-linear=0.134). The multivariable-adjusted incident risk of aortic disease gradually increased with elevated AIP tertiles (adjusted HR (aHR) 1.0 (reference) in tertile 1, aHR 1.48 (95% CI 0.91 to 2.41) in tertile 2, aHR 2.04 (95% CI 1.26 to 3.29) in tertile 3), following an adjustment for age, sex, smoking status, drinking status, body mass index, hypertension, low-density lipoprotein cholesterol and glycated haemoglobin. Specifically, participants in the highest AIP tertile had the highest incident risk of AA, with an aHR of 2.47 (95% CI 1.47 to 4.16). AIP is significantly associated with a higher risk of incident aortic disease, indicating that AIP is an effective risk assessment method for aortic disease, especially for AA.