The Association Between Atherogenic Index of Plasma and Type 2 Diabetes Mellitus in a Multi‐Ethnic Population of Premature Coronary Artery Disease Patients: Insights From IPAD Study

BACKGROUND: The atherogenic index of plasma (AIP) is a lipid-based indicator of cardiometabolic risk. We examined whether AIP is associated with prevalent type 2 diabetes mellitus (T2DM) and fasting blood sugar (FBS) in patients with premature coronary artery disease (PCAD) and explored whether this association differed across Iranian ethnic groups. METHODS: (triglycerides/high-density lipoprotein cholesterol). Multivariable logistic regression was used to assess the association between AIP and prevalent T2DM, and generalized linear models were used to assess the association between AIP and FBS. RESULTS: In the fully adjusted model, including lipid-lowering medication use, participants in the highest AIP quartile had higher odds of prevalent T2DM than those in the lowest quartile (OR: 1.57; 95% CI: 1.14, 2.16; p = 0.005; P for trend = 0.002). Each 1-unit increase in AIP was associated with higher odds of prevalent T2DM (OR: 1.99; 95% CI: 1.26, 3.14; p = 0.003). Higher AIP was also associated with higher FBS; compared with the lowest quartile, the highest quartile had a 15.23 mg/dL higher FBS level in the fully adjusted model (95% CI: 7.61, 22.84; p < 0.001). In exploratory ethnicity-stratified analyses, the association was most evident in the Fars subgroup, while estimates in several smaller ethnic groups were imprecise. CONCLUSIONS: Higher AIP was associated with prevalent T2DM and higher FBS in patients with PCAD. Exploratory analyses suggested possible ethnicity-related heterogeneity, but these subgroup findings should be interpreted cautiously. Prospective studies are needed to determine whether AIP has predictive or clinical risk-stratification value in this population.