AUTHOR=Zhang Yue-Yang , Cao Rui , Wan Qin 

TITLE=Association between the plasma atherogenic index and type 2 diabetes in Chinese population: prospective cohort study based on 4C study

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2025.1571602

DOI=10.3389/fendo.2025.1571602

ISSN=1664-2392

ABSTRACT=BackgroundCurrently, the plasma atherogenic index (AIP) is mainly used to predict atherosclerosis and cardiovascular diseases. Therefore, we aim to investigate the potential association between AIP and type 2 diabetes through a prospective cohort study.MethodsThe 4C study, a multicenter prospective cohort investigation, targets the Chinese population and initially enrolled 10,008 participants. Baseline data encompassing lifestyle, metabolic status, and various other factors were collected in 2011. A 10-year follow-up survey was subsequently conducted, ultimately including 9,092 participants. AIP, defined as the logarithmic transformation of the triglycerides to high-density lipoprotein ratio, was divided into quartiles. To explore the potential association between AIP and the risk of type 2 diabetes, Cox regression, restricted cubic spline, receiver operating characteristic curve(ROC), and subgroup analysis were employed.ResultsOver a 10-year follow-up period, 693 new cases of type 2 diabetes were identified. In a fully adjusted model, AIP demonstrated a positive association with type 2 diabetes (HR: 4.40; 95% CI: 3.21, 6.04). Compared to the Q1 group, the risk of type 2 diabetes increased progressively across the Q2, Q3, and Q4 groups, with a significant trend (p-value < 0.05). Restricted cubic spline (RCS) analysis revealed an inverse L-shaped association between AIP and the risk of type 2 diabetes, with a turning point at 0.45. The ROC analysis indicates that incorporating the AIP into the base model enhances its diagnostic performance for type 2 diabetes. Furthermore, similar patterns were observed in the subgroup analyses.ConclusionsAmong the Chinese population, elevated AIP levels are positively correlated with an increased risk of type 2 diabetes, indicating that AIP could potentially serve as a biomarker for assessing the risk of developing type 2 diabetes.