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Background <p>The atherogenic index of plasma (AIP) has been proposed as a potential predictor of prognosis for atherosclerosis and cardiovascular disease (CVD). However, its prognostic value in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear.</p> Methods <p>This study included 4,062 participants with MASLD from the Third National Health and Nutrition Examination Survey (NHANES III). Kaplan-Meier curves, the Cox proportional hazards regression model, and restricted cubic splines (RCS) were used to assess the associations between the AIP and both all-cause and cause-specific mortality in patients with MASLD. Additionally, subgroup analyses and interaction test were conducted.</p> Results <p>During a median follow-up of 311 months, a total of 1821 (44.83%) all-cause deaths, 606 (14.92%) CVD deaths and 313 (7.71%) diabetes deaths occurred. After adjusting for potential confounding factors, the hazard ratios (HR) for the highest tertile (AIP ≥ 0.30) compared to the lowest tertile (AIP &lt; 0.01) were 1.41 (95% confidence interval [CI]: 1.17–1.68; <i>P</i> &lt; 0.001) for all-cause mortality, 1.49 (95% CI: 1.07–2.09; <i>P</i> = 0.019) for CVD mortality, and 2.27 (95% CI: 1.28–4.01; <i>P</i> = 0.005) for diabetes mortality. Furthermore, subgroup analyses revealed that the highest tertile of AIP was associated with an increased risk of CVD mortality in MASLD patients with diabetes (HR = 2.46; 95% CI: 1.46–4.13; <i>P</i> &lt; 0.001) or obesity/overweight (HR = 2.36; 95% CI: 1.41–3.95; <i>P</i> = 0.001).</p> Conclusions <p>The elevated AIP is independently associated with all-cause mortality, as well as CVD and diabetes mortality in patients with MASLD. AIP can be used as a prognostic indicator for patients with MASLD.</p>

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Prognostic value of atherogenic index of plasma on the all-cause and causes-specific mortality among patients with metabolic dysfunction-associated steatotic liver disease

  • 期刊论文

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  • 发表日期：

    2025年6月14日

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  • Guo Song,
  • Heyu Chu,
  • Yuting Liu,
  • Xiaoli Liu,
  • Rong Gu

摘要

Background

The atherogenic index of plasma (AIP) has been proposed as a potential predictor of prognosis for atherosclerosis and cardiovascular disease (CVD). However, its prognostic value in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear.

Methods

This study included 4,062 participants with MASLD from the Third National Health and Nutrition Examination Survey (NHANES III). Kaplan-Meier curves, the Cox proportional hazards regression model, and restricted cubic splines (RCS) were used to assess the associations between the AIP and both all-cause and cause-specific mortality in patients with MASLD. Additionally, subgroup analyses and interaction test were conducted.

Results

During a median follow-up of 311 months, a total of 1821 (44.83%) all-cause deaths, 606 (14.92%) CVD deaths and 313 (7.71%) diabetes deaths occurred. After adjusting for potential confounding factors, the hazard ratios (HR) for the highest tertile (AIP ≥ 0.30) compared to the lowest tertile (AIP < 0.01) were 1.41 (95% confidence interval [CI]: 1.17–1.68; P < 0.001) for all-cause mortality, 1.49 (95% CI: 1.07–2.09; P = 0.019) for CVD mortality, and 2.27 (95% CI: 1.28–4.01; P = 0.005) for diabetes mortality. Furthermore, subgroup analyses revealed that the highest tertile of AIP was associated with an increased risk of CVD mortality in MASLD patients with diabetes (HR = 2.46; 95% CI: 1.46–4.13; P < 0.001) or obesity/overweight (HR = 2.36; 95% CI: 1.41–3.95; P = 0.001).

Conclusions

The elevated AIP is independently associated with all-cause mortality, as well as CVD and diabetes mortality in patients with MASLD. AIP can be used as a prognostic indicator for patients with MASLD.