ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1653764
This article is part of the Research TopicThe role of Lipids in Relation to Preventing Inflammation and Chronic DiseasesView all 3 articles
Cumulative Atherosclerosis Index of Plasma Exposure and New-onset Diabetes in Middle-Aged and Older Adults: A Prospective Cohort Analysis from the China Health and Retirement Longitudinal Study (CHARLS)
Provisionally accepted
- Nanjing University of Chinese Medicine, Nanjing, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction: China bears the world's largest diabetes burden (116 million adults). The Cumulative Atherosclerosis Index of Plasma (CumAIP), reflecting lipid-driven atherogenicity, may contribute to diabetes pathogenesis. This study investigates longitudinal associations between cumulative CumAIP exposure and diabetes incidence in middle-aged and older Chinese adults. Method: Using data from the China Health and Retirement Longitudinal Study (CHARLS), we analyzed 10395 diabetes-free participants at baseline (2011) with follow-ups in 2013, 2015, and 2018. Multivariable logistic regression adjusted for sociodemographic (age, gender, education), lifestyle (smoking, alcohol, sleep, physical activity), and clinical factors (systolic and diastolic blood pressure, BMI, waist circumference). Restricted cubic splines assessed dose-response relationships. Result: Result: Over 7 years, 793 participants (15.73%) developed diabetes. The highest CumAIP quartile (Q4) had a 3.43-fold elevated diabetes risk versus Q1 (OR = 3.82, 95% CI: 3.13–4.67). A linear dose-response relationship was observed (p for nonlinearity=0.44); each interquartile increase in CumAIP above 1.03 elevated risk by 90% (OR = 1.90, 95% CI: 1.75–2.07). CumAIP predicted diabetes moderately (AUC=0.64, cutoff=1.03). Conclusion: Cumulative CumAIP exposure independently predicts diabetes incidence in middle-to-older adults, highlighting its potential for clinical risk stratification.
Keywords: Cumulative Atherosclerosis Index of Plasma Exposure, New-onset diabetes, dose–response relationship, Restricted cubic spline regression, prospective cohort study
Received: 25 Jun 2025; Accepted: 09 Oct 2025.
Copyright: © 2025 Li, Gu, Chen, Zhao and Wang. 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:
Yu Li, liyu_0630@njucm.edu.cn
Yue Wang, 501368608@qq.com
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.