Atherogenic index of plasma and triglyceride-glucose index mediate the association between stroke and all-cause mortality: insights from the lipid paradox

作者：Jinhua Qian, Qinjie Chi, Chengqun Qian, Xian Fan, Wenbing Ding, Tianle Wang, Zhu Li · 发表于：Lipids in Health and Disease · 年份：2025 · DOI：10.1186/s12944-025-02586-7 · 被引用次数：19 · 研究领域：Diabetes, Cardiovascular Risks, and Lipoproteins、Acute Ischemic Stroke Management、Aortic Thrombus and Embolism

The “lipid paradox” describes the counterintuitive observation that traditionally unfavorable lipid profiles may be associated with improved outcomes in stroke patients. Non-traditional lipid markers such as the atherogenic index of plasma (AIP) and the triglyceride-glucose (TyG) index have been proposed to better reflect the complex metabolic disturbances following stroke. This study aims to investigate the mediating role of AIP and TyG index in the association between stroke and all-cause mortality and elucidate the potential mechanisms underlying the lipid paradox. This cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS), including 10,220 participants enrolled from 2011 to 2020, with a maximum follow-up of 10 years. AIP and TyG index were calculated from baseline serum measurements. U-test, chi-square test, restricted cubic spline analysis (RCS), cox proportional hazards regression and mediation model were used to analyze the relationship between baseline AIP, TyG index, stroke and all-cause mortality. A total of 1,421 deaths (13.90%) occurred during an average follow-up of 9.21 years. Compared to survivors, non-survivors were older, had a higher prevalence of stroke, and lower AIP levels (P < 0.05), while TyG index showed no significant group difference. RCS analysis revealed a nonlinear association between the TyG index and mortality, but no significant nonlinearity for AIP. Cox regression analysis identified age, gender, marital statu...