Association of Atherogenic Index of Plasma With Stroke Risk in a Population With Cardiovascular‐Kidney‐Metabolic Syndrome Stages 0 to 3: The First Evidence From the China Health and Retirement Longitudinal Study

BACKGROUND: The atherogenic index of plasma (AIP) is a marker of lipids and atherosclerosis. However, its associations with stroke risk in a population with cardiovascular-kidney-metabolic (CKM) syndrome stages 0 to 3 remain unclear. METHODS: The data for this study were obtained from CHARLS (China Health and Retirement Longitudinal Study). The AIP was calculated using the formula: AIP=log10 (triglycerides/high-density lipoprotein cholesterol). The outcome of this study was stroke events. Cox regression models and restricted cubic spline were applied to investigate the relationship between AIP and stroke risk in populations with CKM syndrome stages 0 to 3. RESULTS: A total of 7664 participants were included in this study, with a mean age of 59.30±9.58 years, and 53.08% were women. A total of 683 (8.91%) stroke events were recorded. After fully adjusting for covariates, each 1-unit increase in AIP was associated with a 22% increase in stroke risk (hazard ratio HR, 1.22 95% CI, 1.10-1.34). AIP was further categorized into quartiles. The adjusted HRs for quartile 2, quartile 3, and quartile 4 compared with quartile 1 were 1.48 (95% CI, 1.18-1.86), 1.70 (95% CI, 1.36-2.14), and 1.58 (95% CI, 1.25-2.00), respectively. Results from restricted cubic spline revealed a significant nonlinear relationship within a population with CKM syndrome stages 0 to 3 between AIP and stroke risk (threshold=1.516). CONCLUSIONS: This study found a nonlinear association between AIP and increased stroke incidence in a population with CKM syndrome stages 0 to 3, with a threshold of 1.516. These findings indicate that AIP could serve as a potential predictor for the risk of stroke.