{
  "abstract": "Background\n\nCardiometabolic multimorbidity (CMM) poses a growing global health burden, yet effective tools for early risk stratification remain limited. The combined impact of atherogenic dyslipidaemia and physiological frailty, captured by the atherogenic index of plasma-frailty index (AIP-FI), on CMM development is poorly understood. This study aimed to investigate the associations of cumulative exposure and longitudinal trajectories of AIP-FI with incident CMM.Methods\n\nThis prospective cohort study included 4,157 participants aged ≥45 years without baseline CMM from CHARLS. The AIP-FI was constructed as the product of AIP and a 37-deficit frailty index. Cumulative AIP-FI was calculated from repeated measurements. Longitudinal trajectories were identified using K-means clustering. Associations with incident CMM were evaluated by multivariable Cox models, RCS, K-M curves, ROC/NRI/IDI, mediation, interaction, subgroup, and sensitivity analyses.Results\n\nOver a mean 8.5-year follow-up, 612 incident CMM cases occurred. Both higher baseline and cumulative AIP-FI were significantly associated with increased CMM risk, with cumulative exposure showing a stronger effect (fully-adjusted HR per SD increment: 1.46; 95% CI = 1.38-1.54). Participants in the highest quartile of cumulative AIP-FI had a near 4-fold higher CMM risk compared to the lowest (HR = 3.95; 95% CI = 2.95-5.29). Clustering analyses revealed that groups with high-stable AIP-FI exhibited the highest CMM risks. Cumulative AIP-FI demonstrated superior predictive performance for CMM (AUC = 71.17%) and significantly improved risk reclassification over traditional markers (NRI = 0.157). Mediation analyses suggested bidirectional synergistic effects between AIP and FI.Conclusions\n\nIn this national cohort, both the cumulative burden and adverse longitudinal trajectories of AIP-FI were independently associated with an elevated risk of CMM. Dynamic monitoring of this composite biomarker could facilitate the early identification of high-risk individuals, thereby informing targeted prevention strategies for middle-aged and older adults in China.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, The First Hospital of Jilin University, Changchun, China.",
    "Department of Geriatrics, Ruijin Hospital Lu Wan Branch, Shanghai Jiaotong University School of Medicine, Shanghai, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Haidi Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Zikai Song"
    },
    {
      "affs": [
        1
      ],
      "name": "Tengfei Ye"
    },
    {
      "affs": [
        1
      ],
      "name": "Chunhua Yang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ax578a7y8kne4.bib",
  "cited_by": 0,
  "doi": "10.7189/jogh.16.04319",
  "fulltext_url": "https://europepmc.org/articles/PMC13679350",
  "id": "ax578a7y8kne4",
  "issns": [
    "2047-2978",
    "2047-2986"
  ],
  "landing_url": "https://europepmc.org/article/MED/42895260",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2713|Chronic Disease Management Strategies"
    ]
  ],
  "openalex": "W7222986046",
  "pdf_url": "https://europepmc.org/articles/PMC13679350?pdf=render",
  "pmcid": "PMC13679350",
  "pmid": "42895260",
  "published": "2026-10-19",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/ax578a7y8kne4.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:33Z",
      "native_id": "MED:42895260",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42895260"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Chronic Disease Management Strategies",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Associations of cumulative exposure and dynamic trajectories of the combined atherogenic-frailty index with incident cardiometabolic multimorbidity: a prospective cohort study.",
  "title_text": "Associations of cumulative exposure and dynamic trajectories of the combined atherogenic-frailty index with incident cardiometabolic multimorbidity: a prospective cohort study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:33Z",
  "url": "https://research.draconitic.com/paper/ax578a7y8kne4",
  "venue": "Journal of global health",
  "versions": []
}