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Letter to the Editor: The atherogenic index of plasma as a predictor of mortality in patients with COVID-19

Published:September 13, 2022DOI:https://doi.org/10.1016/j.hrtlng.2022.09.006

      Letter

      To the Editor
      The article "The atherogenic index of plasma as a predictor of mortality in patients with COVID-19" by Özge Turgay Yıldırım et al. has been read with great interest.
      • Turgay Yıldırım Ö
      • Kaya Ş.
      The atherogenic index of plasma as a predictor of mortality in patients with COVID-19.
      It was a pleasure to read such a well-written paper, and we commend the authors' extraordinary efforts. We agree with the conclusion of the article that the Atherogenic Index of Plasma (AIP) can be used as a biomarker for mortality in COVID-19 patients. As a result, patients with higher AIP values should be carefully monitored and treated. With this, higher triglyceride levels and lower total cholesterol, LDL-C, and HDL-C values are observed in COVID patients who died, which may be a result of the SARS effect of COV-2 on the lipid metabolism of the host subject. Nonetheless, it appeared that a few additional points would have made the article better.
      In the first place, the authors should have mentioned that the AIP has been demonstrated to have a good predictive potential for ischemic heart disease as well, as this would have made the AIP a reliable and independent value for stratifying numerous cardiometabolic risks in COVID-19 patients.
      • Kim JJ
      • Yoon J
      • Lee YJ
      • Park B
      • Jung DH.
      Predictive Value of the Atherogenic Index of Plasma (AIP) for the Risk of Incident Ischemic Heart Disease among Non-Diabetic Koreans.
      Secondly, the ethnicity of the patients should have been indicated throughout the research, as this would have revealed more information about a diverse community. As a result, a research's logistic regression analysis showed that a moderate course of COVID-19 among Novosibirsk women is associated with BMI (odds ratio (OR) = 1.090, 95% confidence interval (95% CI) 1.019–1.166, p = 0.012), and a severe course is associated with WC (OR = 1.041, 95% CI 1.001–1.084, p = 0.046), compared to both mild (OR = 13.824, 95% CI 1.505–126.964, p = 0.02) and moderate (OR = 11.579).
      • Evdokimova N.E.
      • Stryukova E.V.
      • Maslatsov N.A.
      • Khudyakova A.D.
      • Volkova M.V.
      • Logvinenko I.I.
      Association of lipid profile parameters, plasma atherogenic index, anthropometric parameters with the severity of covid-19 in women in Novosibirsk.
      In addition, when calculating AIP, the unit of both triglyceride (TG) and high-density lipoprotein (HDL) levels should be mmol. However, the author used mg/dl units when calculating the AIP value. Additionally, the TG level is an accurate indicator of cardiovascular disease. Among other atherogenic LDL subtypes, small dense LDL (sLDL) exerts the greatest atherogenic effect.
      • Orekhov AN
      • Bobryshev YV
      • Sobenin IA
      • Melnichenko AA
      • Chistiakov DA.
      Modified low density lipoprotein and lipoprotein-containing circulating immune complexes as diagnostic and prognostic biomarkers of atherosclerosis and type 1 diabetes macrovascular disease.
      The TG level corresponds to the sLDL level.
      • Cure E
      • Icli A
      • Uslu AU
      • Sakiz D
      • Cure MC
      • Baykara RA
      • Yavuz F
      • Arslan S
      • Kucuk A.
      Atherogenic index of plasma: a useful marker for subclinical atherosclerosis in ankylosing spondylitis: AIP associate with cIMT in AS.
      In determining atherogenic risk, the TG value is very significant. cLDL is responsible for endothelial dysfunction and the increased production of reactive oxygen radicals. Nonetheless, there is no evidence in the scientific literature that cLDL is more atherogenic than sLDL.

      Declaration of Competing Interest

      None

      Acknowledgment

      None

      Funding

      None

      References

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        • Kaya Ş.
        The atherogenic index of plasma as a predictor of mortality in patients with COVID-19.
        Heart Lung. 2021; 50 (Mar-AprDoiEpub 2021 Jan 26. PMID: 33524862; PMCID: PMC7837614): 329-333https://doi.org/10.1016/j.hrtlng.2021.01.016
        • Kim JJ
        • Yoon J
        • Lee YJ
        • Park B
        • Jung DH.
        Predictive Value of the Atherogenic Index of Plasma (AIP) for the Risk of Incident Ischemic Heart Disease among Non-Diabetic Koreans.
        Nutrients. 2021 Sep 16; 13 (DoiPMID: 34579107; PMCID: PMC8471973): 3231https://doi.org/10.3390/nu13093231
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        • Stryukova E.V.
        • Maslatsov N.A.
        • Khudyakova A.D.
        • Volkova M.V.
        • Logvinenko I.I.
        Association of lipid profile parameters, plasma atherogenic index, anthropometric parameters with the severity of covid-19 in women in Novosibirsk.
        Atherosclerosis. 2021; 17: 20-27https://doi.org/10.52727/2078-256X-2021-17-4-20-27
        • Orekhov AN
        • Bobryshev YV
        • Sobenin IA
        • Melnichenko AA
        • Chistiakov DA.
        Modified low density lipoprotein and lipoprotein-containing circulating immune complexes as diagnostic and prognostic biomarkers of atherosclerosis and type 1 diabetes macrovascular disease.
        Int J Mol Sci. 2014 Jul 21; 15 (DoiPMID: 25050779; PMCID: PMC4139876): 12807-12841https://doi.org/10.3390/ijms150712807
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        • Sakiz D
        • Cure MC
        • Baykara RA
        • Yavuz F
        • Arslan S
        • Kucuk A.
        Atherogenic index of plasma: a useful marker for subclinical atherosclerosis in ankylosing spondylitis: AIP associate with cIMT in AS.
        Clin Rheumatol. 2018 May; 37 (DoiEpub 2018 Feb 12. PMID: 29435680): 1273-1280https://doi.org/10.1007/s10067-018-4027-0