Association Between Atherogenic Index of Plasma and Endometriosis: Evidence from NHANES 1999-2006

Lei Liu, Liwen Liu, Gaosheng Su, Guosheng Su, Jie Rao, Jinming Peng, Juanbao Peng, Xiu Lin, Lin Xiu, Yu-Jie Huang, Yujie Huang, Feng Liang, Chenwei Feng, Chuanxia Feng, Zhong Lin
International journal of women's health · 2025 · vol. Volume 17 , pp. 2175–2184 · doi:10.2147/ijwh.s516740 · PMID:40703855 · PMC12284238 · W4412650275
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found that higher atherogenic index of plasma (AIP) levels are positively associated with an increased risk of endometriosis in a nationally representative sample.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

Using data from 1999–2006 NHANES, this cross-sectional study analyzed 1,817 participants (146 reporting a doctor-diagnosed history of endometriosis) to test whether the atherogenic index of plasma (AIP; log10[TG/HDL-C]) is associated with endometriosis risk, using weighted multivariable logistic regression, restricted cubic splines, subgroup analyses, and an XGBoost ranking of lipid indicators. After full covariate adjustment, higher AIP was associated with endometriosis (continuous OR=2.578, 95% CI: 1.232–5.394, P=0.013), and participants in the highest AIP quartile had higher endometriosis frequency than those in the lowest quartile (OR=1.762, 95% CI: 1.056–3.103, P=0.047), with restricted cubic splines indicating a linear trend and no significant subgroup interaction effects. The paper’s key limitation is its cross-sectional design with endometriosis assessed via self-reported questionnaire history rather than clinical confirmation, which constrains causal inference. This paper is centrally about endometriosis — it examines the association between AIP and the reported prevalence of endometriosis in a nationally representative US sample.

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Abstract

BACKGROUND AND AIMS: Due to its association with various diseases, atherogenic index of plasma (AIP) has garnered increasing attention. Exploration of the relationship between AIP and endometriosis risk has not been thorough. This nationwide study will attempt to explore this association. This cross-sectional study aimed to investigate this association using a nationally representative sample. METHODS: We utilized a nationally representative dataset from the 1999-2006 NHANES, including 1817 participants. AIP was defined as log10 (triglycerides/high-density lipoprotein cholesterol). An examination of the relationship between AIP and endometriosis utilized methods including weighted multivariable logistic regression, restricted cubic splines, and subgroup analyses. The relative significance of various lipid indicators was evaluated with the Extreme Gradient Boosting (XGBoost) algorithm. RESULTS: This study analyzed 1817 participants, among whom 146 were diagnosed with endometriosis. Upon full adjustment for relevant covariates, the continuous model through multivariable logistic regression demonstrated a notable association between heightened AIP levels and the risk of endometriosis (OR = 2.578, 95% CI: 1.232-5.394, P = 0.013). In the categorical model, the incidence of endometriosis in the highest AIP quartile was 1.762 times that in the lowest AIP quartile (OR = 1.762, 95% CI: 1.056-3.103), P = 0.047). Interaction tests in subgroup analyses did not significantly affect this association. A linear correlation between AIP and endometriosis was observed within the constraints of the restricted cubic spline regression model. The machine learning results indicate that AIP is the most critical lipid indicator. CONCLUSION: Our analysis confirms a positive correlation between elevated AIP levels and the frequency of endometriosis cases. This indicates that therapeutic strategies aimed at reducing AIP levels might have a beneficial impact on the management of endometriosis.

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endometriosis

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