内脏脂肪指数介导血浆动脉粥样硬化指数与胆结石之间的关系探讨:一项基于5865名人群的横断面研究OA

Objective To investigate the correlation between the atherogenic index of plasma(AIP)and gallstones and to assess the potential mediating role of the visceral adiposity index(VAI)in this association.Methods Based on data from the US National Health and Nutrition Examination Survey(NHANES)2017-2020,participants aged≥20 years were enrolled.Baseline data,including age,gender,ethnicity/race,and other variables,were collected.Participants were divided into gallstone group(n=627)and non-gallstone group(n=5238)based on whether they had gallstones.AIP,as the exposure variable,was grouped into quartiles(Q1-Q4)to assess its association with gallstones;VAI was included in the mediation analysis.A multivariate logistic regression model was used to analyze the association between AIP and the risk of gallstone.A multiple linear regression model was employed to assess the correlation between AIP and VAI.Subgroup analysis,interaction tests,restrictive cubic spline(RCS)analysis,and mediation effect analysis were conducted to explore the AIP-gallstone relationship and the potential mediating effect of VAI.Results A total of 5865 eligible participants were included,of whom 627 self-reported gallstones,resulting in a prevalence of 10.7%.When AIP was grouped by quartiles,the prevalence of gallstones showed an increasing trend,with rates of 7.1%,10.0%,12.7%,and 13.0%in Q1 to Q4 groups,respectively(P<0.001).Multivariate logistic regression analysis revealed that higher AIP was significantly positively associated with an increased risk of gallstones(fully adjusted model:OR=1.81,95%CI 1.33-2.44,P=0.0001);the risk in Q4 group was 76%higher than that in Q1 group.VAI was also positively associated with gallstone risk(OR=1.03,95%CI 1.00-1.06,P=0.0421).Multivariate linear regression indicated a stable positive correlation between AIP and VAI(β=6.29,P<0.0001),which increased with rising AIP quartiles(P<0.0001).Subgroup analyses revealed that this association was more pronounced in females,individuals under 60 years of age,non-Mexican Americans,and those with a high school education or higher,with an interaction effect observed for gender(Pinteraction=0.0418).RCS analysis indicated a nonlinear relationship between AIP and gallstone risk,with an inflection point at 0.37,where risk increased significantly with rising AIP prior to the inflection point.Mediation analysis suggested that VAI might play a role in the association between AIP and gallstone risk,but no significant mediating effect was observed(P=0.134).Conclusions A significant nonlinear positive correlation exists between AIP and the risk of gallstones.Although VAI is highly correlated with AIP and is associated with gallstone risk,its role as a mediator was not statistically significant in this study,suggesting that its mediating effect in the pathway from AIP to gallstone risk remains unclear.