Evidence map›Paper›PMID 41071474›Full record

ArticleClinical rheumatology2025

Cumulative atherogenic index of plasma exposure and cardiovascular disease risk: the mediating role of frailty in a Chinese middle-aged and elderly population.

Yan Lin, Xiaocan Jia, Xuezhong Shi, Jingwen Fan, Jiaqi Sun, Yishuo Gao, Yongli Yang

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Article in Clinical rheumatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

7 authors.

Yan LinDepartment of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China.
Xiaocan JiaDepartment of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China.
Xuezhong ShiDepartment of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China.
Jingwen FanDepartment of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China.
Jiaqi SunDepartment of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China.
Yishuo GaoDepartment of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China.
Yongli YangDepartment of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001, Henan, China. ylyang377@zzu.edu.cn.ORCID http://orcid.org/0000-0003-0895-2957

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAtherosclerosis have been implicated in cardiovascular disease (CVD) risks, and whether frailty played a mediating role in this association was unclear.

objectivesThis study aimed to assess the associations of cumulative atherosclerosis index of plasma (CumAIP) exposure with incidence of CVD and evaluate the mediating role of frailty.

methodsThe study analyzed data from the China Health and Retirement Longitudinal Study (CHARLS) cohort. Triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) were extracted to calculate the CumAIP. Frailty was assessed using the frailty index (FI). CVD events were confirmed based on medical history. Cox proportional hazards, linear regression, and restricted cubic spline (RCS) models were employed, along with mediation analysis.

resultsIncreased atherosclerosis was associated with increased risks of CVD. In the fully adjusted Cox model, compared to the CumAIP Q1 group, the HR and 95% confidence intervals (CI) of the Q3-Q4 groups in model 3 were 1.320 (95% CI 1.104-1.579) and 1.396 (95% CI 1.164-1.675), respectively. The CumAIP level demonstrated a positive association with frailty, with β (95% CI) of 0.016 (95% CI 0.003-0.010) in response to per 0.1 increment in CumAIP. The frailty mediated the association between atherosclerosis and CVD risk. The proportions of mediation were 11.81% between CumAIP and CVD. Subgroup and sensitivity analyses confirmed the robustness of these findings.

conclusionsAtherosclerosis was linked to increased risks of CVD. The frailty partially mediated the association between atherosclerosis and CVD. These results highlighted the significance of interventions targeting atherosclerosis and frailty in CVD prevention and management. Key Points • This study found a significant association between higher CumAIP levels and increased CVD risk, highlighting the impact of long-term lipid abnormalities on cardiovascular health. • Frailty played as a partial mediator in the link between CumAIP and CVD, highlighting its importance in the progression from atherosclerosis to CVD.

Indexed as

AtherosclerosisCardiovascular DiseasesFrailtyTriglyceridesAgedChinaCholesterol, HDLEast Asian PeopleFemaleHumansIncidenceLongitudinal StudiesMaleMiddle AgedProportional Hazards ModelsRisk FactorsCholesterol, HDLTriglyceridesAtherogenic index of plasmaCardiovascular diseaseCumulative exposureFrailtyMediation

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PMID41071474

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