Association of the atherogenic index of plasma and high-sensitivity C-reactive protein with incident cardiovascular disease: evidence from a national cohort of middle-aged and older Chinese adults

作者：Pingan Lian, Fei Xie, Weidong Zhang, Shuai Cheng, Yunfei Zhao, Dan Li, Shan-fu Liang, Zhan-zhan Zhu, Jun-yue Zhang, Jiao-jiao Cui, Jie Du, Lei Yin, S. Zhang · 发表于：Frontiers in Endocrinology · 年份：2025 · DOI：10.3389/fendo.2025.1618157 · 被引用次数：8 · 研究领域：Adipokines, Inflammation, and Metabolic Diseases、Inflammatory Biomarkers in Disease Prognosis、Nutritional Studies and Diet

Background The atherogenic index of plasma (AIP), an emerging biomarker of lipid dysregulation, and high-sensitivity C-reactive protein (hs-CRP), an established marker of inflammation, are both implicated in the development of cardiovascular disease (CVD). However, their joint impact on CVD risk and the underlying mediation mechanisms remain unclear. Methods This study used data from the China Health and Retirement Longitudinal Study (CHARLS), including 8,763 adults aged ≥45 years with up to 9 years of follow-up. Baseline AIP and hs-CRP levels were measured, and participants were divided into four groups based on the AIP median and hs-CRP threshold (1 mg/L). Multivariable Cox models assessed associations with CVD. Mediation analyses examined direct and indirect effects, including bidirectional mediation. Additive interaction was evaluated using the relative excess risk due to interaction (RERI), and predictive performance was assessed via Receiver Operating Characteristic Curve (ROC) curve analysis. Results A total of 1,693 participants developed CVD during the follow-up period. Higher levels of AIP and hs-CRP were independently associated with CVD. Joint analysis showed that, compared with individuals with AIP below the median and hs-CRP <1 mg/L, those with elevated levels of both AIP and hs-CRP had the highest risks of CVD (HR: 1.655; 95% CI: 1.455-1.883), heart disease (HR: 1.402; 95% CI: 1.207-1.628), and stroke (HR: 2.207; 95% CI: 1.771-2.749). These associations ...