Sex-specific differences in the effect of the atherogenic index of plasma on prediabetes and diabetes in the NHANES 2011–2018 population

Background Although a great deal of scientific evidence on the epidemiological risk factors for diabetes and prediabetes has been accumulated, there is still insufficient evidence to explore sex-related differences.

The aim of this study was to examine sex-specific differences in the effect of the atherogenic index of plasma (AIP) on prediabetes and diabetes.

Methods This cross-sectional study included data from 10099 American adults.

The exposure variable was the AIP, which was defined as log10 (triglycerides/high-density lipoprotein cholesterol).

The outcome variables included prediabetes and diabetes defined by the 2013 American Diabetes Association guidelines.

Results The median age (mean ± SD) was 48.51 ± 18.42 years, and the average value (SD) of the AIP was − 0.09 (0.34).

The prevalence of prediabetes was 40.24%, and that of diabetes was 21.32%.

Overall, there was a significant positive association between the AIP and prediabetes and diabetes (per 1-unit increment in the AIP: OR, 2.49; 95% CI 1.75, 3.54).

The multivariate logistic regression model demonstrated that for each unit increment in the AIP, the prediabetes and diabetes prevalence increased 4.96-fold among female participants (OR 4.96, 95% CI 2.68, 9.18) but not among male participants.

We found that the AIP was not related to the prevalence of prediabetes or diabetes (OR 1.41; 95% CI 0.87, 2.29) among males.

There was an interaction between sex and the AIP (P for interaction < 0.0001).

Conclusions This study showed that a higher AIP was significantly associated with an increased prevalence of prediabetes and diabetes, and the above relationships occurred only among women and not men.