Atherosclerosis. 2025 Oct 10;410:120545. doi: 10.1016/j.atherosclerosis.2025.120545. Online ahead of print.
ABSTRACT
BACKGROUND AND AIMS: The atherogenic index of plasma (AIP) has been linked to hypertension in general populations. However, the existing evidence concerning its association with preeclampsia risk remains limited. This study aimed to assess the relationship between first-trimester AIP level and preeclampsia risk.
METHODS: 6028 singleton pregnant women from a birth cohort, all under 14 weeks of gestation and without a history of hypertension, were included. AIP was calculated as log10 (triglycerides/high-density lipoprotein cholesterol). Generalized linear models and restricted cubic spline regression were utilized to estimate the associations between AIP and preeclampsia risk. A random forest model was employed to determine the relative importance of parameters for predicting preeclampsia risk.
RESULTS: 235 (3.90%) incident preeclampsia cases were confirmed. A linear relationship was found between AIP and preeclampsia risk, and each 1-standard deviation increase in AIP was associated with a 21% higher risk of preeclampsia (RR: 1.21, 95% CI: 1.06-1.38). A significant interaction was identified between AIP and uric acid (UA) level (P for interaction = 0.009). Elevated AIP was linked to an increased preeclampsia risk (RR: 1.32, 95% CI: 1.13-1.54) when UA level exceeded 198 μmol/L, and the highest combined level indicated the greatest risk. Moreover, AIP was identified as the strongest predictor among all variables in the prediction model.
CONCLUSIONS: Elevated first-trimester AIP was associated with an increased preeclampsia risk, particularly at the higher UA level. These findings highlight the clinical significance of pro-atherogenic dyslipidemia as both a risk marker and a potential target for early screening in preeclampsia prevention strategies.
PMID:41092517 | DOI:10.1016/j.atherosclerosis.2025.120545
