{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T15:11:10Z","timestamp":1778771470828,"version":"3.51.4"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"\n Background<\/jats:title>\n Emerging evidence suggests that the atherogenic index of plasma (AIP), a simple marker of lipid-related metabolic risk, may relate to dysglycemia in a nonlinear fashion. However, whether this association differs across body mass index (BMI) categories, particularly in terms of nonlinear risk patterns and thresholds, remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We analyzed data from 100,473 Chinese adults who underwent baseline health examinations and had baseline FPG &lt; 5.6 mmol\/L. Because HbA1c and OGTT data were unavailable, the outcome was defined as FPG-defined incident prediabetes (5.6-6.9 mmol\/L). Participants were classified into underweight, normal weight, overweight, and obesity groups according to Chinese BMI criteria. Restricted cubic spline (RCS) and Cox regression were used to evaluate BMI-specific associations between AIP and prediabetes risk and to test for interaction by BMI.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n During a median follow-up of 3.0 years, 12,371 participants developed FPG-defined incident prediabetes. A significant interaction between AIP and BMI was observed (P for interaction &lt; 0.001). BMI-stratified analyses showed that AIP was associated with FPG-defined prediabetes risk only among normal-weight and overweight participants, but not among underweight or obese participants. RCS analyses further identified nonlinear associations in these two BMI groups, with model-derived inflection points at AIP = -0.20 in normal-weight individuals and AIP\u00a0=\u00a00.057 in overweight individuals.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n BMI modified the association between AIP and FPG-defined prediabetes risk. Significant nonlinear and threshold-dependent associations were observed only in normal-weight and overweight Chinese adults.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fendo.2026.1813692","type":"journal-article","created":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T14:40:41Z","timestamp":1778769641000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["BMI-specific nonlinear associations and threshold effects of the atherogenic index of plasma on incident prediabetes: insights from 100473 Chinese adults"],"prefix":"10.3389","volume":"17","author":[{"given":"Bing","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Jinshan Branch of Shanghai Sixth People\u2019s Hospital","place":["Shanghai, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weiqin","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Jinshan Branch of 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