ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1627337
Sex differences in the association between atherogenic index of plasma and progression from normoglycemia to prediabetes: evidence from a 5-Year largescale retrospective cohort study
Provisionally accepted
- 1ChenTian Community Health Service Centre, Shenzhen Bao'An District Central Hospital, shenzhen, China
- 2Shenzhen Dapeng New District Kuichong People's Hospital, shenzhen, China
- 3Shenzhen Second People's Hospital, shenzhen, China
- 4Shenzhen University, Shenzhen, China
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Objective: Currently, there is limited research on the relationship between the atherogenic index of plasma (AIP) and the risk of prediabetes (pre-DM). This study aims to explore the potential link between AIP and the risk of progression from normoglycemia to pre-DM. Methods: In this retrospective cohort analysis, a total of 8,295 individuals receiving routine medical examinations at Kuichong People's Hospital in Shenzhen between January 2018 and December 2023 were enrolled. The Cox proportional hazards regression model assessed the association between AIP and the risk of progression from normoglycemia to pre-DM, with restricted cubic splines functions used to assess nonlinear relationships. Additionally, a competing risk Cox model was used, treating the progression from normoglycemia to diabetes (DM) as a competing event for pre-DM. Finally, the subgroup and sensitivity analyses confirmed the robustness of the findings. Results: After multivariable adjustment, each 0.1-unit increase in AIP was associated with an 11.5% increase in the risk of progression from normoglycemia to pre-DM (HR=1.115, 95% CI: 1.065–1.167). The competing risk Cox model showed that the sub-distribution hazard ratio (SHR) for the association between AIP and the risk of pre-DM was 1.09 (95% CI: 1.04–1.14). Additionally, a nonlinear association was observed in males, with an inflection point at 0.513. Below this threshold, each 0.1-unit increase in AIP was associated with an HR of 1.204 (95% CI: 1.098–1.321). In females, the relationship was linear. Conclusion: This study demonstrated that elevated AIP was positively associated with the risk of progression from normoglycemia to pre-DM, with a significant sex difference in this relationship. This provides a reference for individualized risk stratification and management strategies for different sex populations and offers new perspectives for optimizing strategies to prevent pre-DM and DM.
Keywords: Atherogenic index of plasma, prediabetes, nonlinearity, Competing risk model, sex differences
Received: 12 May 2025; Accepted: 11 Jul 2025.
Copyright: © 2025 Yang, Che, Li, Gao, Han and zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: jiaqian zhu, Shenzhen University, Shenzhen, China
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