Key result
Non-HDL cholesterol and AIP linked to increased carotid thickness and arterial stiffness in spondyloarthritis.
Cross-Sectional (n=150)
No
Effect estimate: B = 0.027 (95% CI 0.002-0.053)
p-value: p=0.033
In patients with spondyloarthritis, atherogenic lipid indices such as non-HDL-C and AIP are independently associated with subclinical atherosclerosis and arterial stiffness, suggesting they may provide complementary information for cardiovascular risk assessment.
AIP and non-HDL-C associations with vascular markers in spondyloarthritis are hypothesis-generating; leaves open their role in CV risk stratification pending longitudinal data.
Background Patients with spondyloarthritis (SpA) have an increased risk of cardiovascular disease that is not fully explained by traditional cardiovascular risk factors. Chronic inflammation may alter lipid metabolism and contribute to the lipid paradox, limiting the value of conventional lipid parameters for cardiovascular risk assessment. Composite atherogenic lipid indices have emerged as potential markers of residual cardiovascular risk, but their relationship with subclinical vascular damage in SpA remains incompletely understood. Objective To investigate the association between atherogenic lipid indices and markers of subclinical atherosclerosis and arterial stiffness in patients with spondyloarthritis. Methods This cross-sectional study included 150 patients with SpA, comprising 109 patients with ankylosing spondylitis and 41 patients with psoriatic arthritis. Lipid profile, atherogenic index of plasma (AIP), Castelli risk indices I and II, non-high-density lipoprotein cholesterol (non-HDL-C), and atherogenic coefficient were assessed. Carotid intima-media thickness (CIMT) and arterial stiffness parameters, including local carotid pulse wave velocity (PWV), β-stiffness, pressure-strain elastic modulus (EP), arterial compliance (AC), and augmentation index (AI), were evaluated using carotid ultrasonography with echo-tracking technology. Associations were analyzed using Spearman correlation and multivariable linear regression models. Results Triglycerides demonstrated the strongest and most consistent correlations with vascular parameters, including CIMT (ρ = 0.241, p = 0.003), β-stiffness (ρ = 0.314, p < 0.001), local carotid PWV (ρ = 0.325, p < 0.001), and EP (ρ = 0.318, p < 0.001). Non-HDL-C was significantly associated with CIMT (ρ = 0.248, p = 0.002), β-stiffness (ρ = 0.195, p = 0.017), local carotid PWV (ρ = 0.249, p = 0.002), and EP (ρ = 0.225, p = 0.006). AIP correlated positively with CIMT, β-stiffness, local carotid PWV, and EP and remained independently associated with local carotid PWV after multivariable adjustment (B = 0.534, 95% CI 0.005–1.063; β = 0.150, p = 0.048), whereas non-HDL-C remained independently associated with CIMT (B = 0.027, 95% CI 0.002–0.053; β = 0.149, p = 0.033). In contrast, LDL-C and HDL-C demonstrated limited associations with vascular parameters. Conclusions Atherogenic lipid indices are associated with carotid structural and functional vascular parameters in patients with spondyloarthritis. Non-HDL-C and AIP were independently associated with CIMT and PWV, respectively, suggesting that these indices may provide complementary information regarding vascular characteristics in patients with SpA.
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Markov et al. (2026) conducted a cross-sectional in Spondyloarthritis (n=150). Atherogenic lipid indices (Non-HDL-C and AIP) was evaluated on Carotid intima-media thickness (CIMT) (B = 0.027, 95% CI 0.002-0.053, p=0.033). In patients with spondyloarthritis, non-HDL cholesterol was independently associated with increased carotid intima-media thickness (B = 0.027), and the atherogenic index of plasma was independently associated with local carotid pulse wave velocity (B = 0.534).
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