Evidence map›Paper›PMID 42289689›Full record

ArticleCardiovascular diabetology2026

Associations of the atherogenic index of plasma and its modified indices with the incidence and progression of cardiometabolic multimorbidity in individuals with cardiovascular-kidney-metabolic syndrome stages 0-3: a prospective cohort study.

Fei Xue, Qingmei Han, Yifei Li, Cheng Cheng, Lin Xie, Jianmin Yang, Jiye Wan

Abstract read
In one paragraph

Article in Cardiovascular diabetology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Fei Xue *State Key Laboratory for Innovation and Transformation of Luobing Theory, Key Laboratory of Cardiovascular Remodeling and Function Research of MOE, NHC, CAMS and Shandong Province, Department of Cardiology, Qilu Hospital of Shandong University, No. 107, Wen Hua Xi Road, Jinan, 250012, Shandong, People's Republic of China.
Qingmei Han *State Key Laboratory for Innovation and Transformation of Luobing Theory, Key Laboratory of Cardiovascular Remodeling and Function Research of MOE, NHC, CAMS and Shandong Province, Department of Cardiology, Qilu Hospital of Shandong University, No. 107, Wen Hua Xi Road, Jinan, 250012, Shandong, People's Republic of China.
Yifei Li *State Key Laboratory for Innovation and Transformation of Luobing Theory, Key Laboratory of Cardiovascular Remodeling and Function Research of MOE, NHC, CAMS and Shandong Province, Department of Cardiology, Qilu Hospital of Shandong University, No. 107, Wen Hua Xi Road, Jinan, 250012, Shandong, People's Republic of China.
Cheng ChengDepartment of Cardiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning, People's Republic of China.
Lin XieState Key Laboratory for Innovation and Transformation of Luobing Theory, Key Laboratory of Cardiovascular Remodeling and Function Research of MOE, NHC, CAMS and Shandong Province, Department of Cardiology, Qilu Hospital of Shandong University, No. 107, Wen Hua Xi Road, Jinan, 250012, Shandong, People's Republic of China. sduxielin@163.com.
Jianmin YangState Key Laboratory for Innovation and Transformation of Luobing Theory, Key Laboratory of Cardiovascular Remodeling and Function Research of MOE, NHC, CAMS and Shandong Province, Department of Cardiology, Qilu Hospital of Shandong University, No. 107, Wen Hua Xi Road, Jinan, 250012, Shandong, People's Republic of China. yangjianminsdu@163.com.
Jiye WanDepartment of Cardiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning, People's Republic of China. jywan@cmu.edu.cn.

Funding

Joint Project of Liaoning Provincial Science and Technology Plan 2023-BSBA-345National Natural Science Foundation of China 82400415Natural Science Foundation of Shandong Province ZR2024QH224Taishan Scholars Program of Shandong Province tsqn202408350
6 · The paper itself

Abstract

backgroundCardiovascular-kidney-metabolic (CKM) syndrome stages 0-3 reflect a heterogeneous continuum of metabolic, kidney, and cardiovascular abnormalities that are closely associated with the development of cardiometabolic diseases (CMDs). Although the atherogenic index of plasma (AIP) and obesity-related composite indices have been associated with individual CMDs, their associations with cardiometabolic multimorbidity (CMM) among individuals with CKM syndrome remain unclear. This study primarily investigated whether AIP-related indices were associated with the incidence and progression of CMM in individuals with CKM syndrome stages 0-3.

methodsThis prospective cohort study included 346,868 UK Biobank participants without baseline type 2 diabetes (T2DM), coronary heart disease (CHD), or stroke. CMM was defined as the coexistence of at least two of these conditions. Cox proportional hazards models were used to estimate associations with incident CMM, while multistate models were applied to characterize disease progression. As secondary analyses, the added predictive value of each index was assessed using discrimination and reclassification metrics. Exploratory biomarker analyses examined whether inflammatory, liver, and renal biomarkers statistically accounted for part of the associations.

resultsDuring a median follow-up of 15.9 years, 8573 participants developed CMM. All eight AIP-related indices were positively associated with incident CMM, with hazard ratios per 1-SD increment ranging from 1.12 to 1.37 (all P < 0.001). Multistate analyses suggested stage-specific associations during CMM progression, with stronger associations observed for the transition from baseline to T2DM and from single CMD to CMM involving CHD (all P < 0.001). In secondary prediction analyses, adding each index to conventional risk factors improved discrimination and reclassification, with the AIP-body roundness index (AIP-BRI) showing the greatest overall incremental predictive value. Exploratory biomarker analyses indicated that inflammatory, liver, and renal biomarkers jointly accounted for 32.5-46.4% of the associations, although these findings should not be interpreted as evidence of causal mediation.

conclusionAmong individuals with CKM syndrome stages 0-3, AIP-related indices were positively associated with the incidence and progression of CMM, supporting their potential utility for CMM risk stratification within the CKM framework. These indices, particularly AIP-BRI, may provide additional predictive information. Exploratory biomarker findings might provide preliminary clues for future mechanistic research.

Indexed as

Cardio-Renal SyndromeMetabolic SyndromeAdultAgedBiomarkersCardiometabolic Risk FactorsDisease ProgressionFemaleHumansIncidenceMaleMiddle AgedMultimorbidityPredictive Value of TestsPrognosisProspective StudiesBiomarkersAtherogenic index of plasmaCardiometabolic multimorbidityCardiovascular-kidney-metabolic syndromeCohort studyIncidenceMediating biomarkersObesity-related derivativesPredictive valueProgression

Identifiers

PMID42289689
PMCPMC13491610

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.