[Association between the atherogenic index of plasma and cognitive impairment in patients on maintenance hemodialysis].

<b>Objective:</b> To explore the association between the atherogenic index of plasma (AIP) and cognitive impairment (CI) in patients on maintenance hemodialysis (MHD). <b>Methods:</b> A multicenter cross-sectional study was conducted between June and August 2022, involving adult MHD patients from 18 hemodialysis centers in Guizhou Province. Cognitive function was assessed by Mini Mental State Examination (MMSE) scale. General data and laboratory parameters of patients were collected, and the AIP was calculated. Participants were divided into four groups (Q1-Q4) based on the quartiles of the AIP. Multivariate logistic regression analysis was used to analyze the association between AIP and CI, and subgroup analysis was performed. <b>Results:</b> A total of 1 031 MHD patients aged (56.0±15.0) years were enrolled in the study, with 621 males (60.2%) and 410 females (39.8%), of whom 491 patients (47.6%) had CI. After adjusting for confounders, the risk of CI in Q4 group (AIP≥0.30) was 2.17 times that of the Q1 group (AIP<-0.13) (<i>OR</i>=2.17, 95%<i>CI</i>: 1.47-3.22, <i>P</i><0.001). Subgroup analysis revealed that elevated AIP levels (Q4) correlated with a higher risk of CI in males, younger and middle-aged populations, as well as in subgroups with diabetes or hypertension (all <i>P</i><0.05). Notably, in patients aged 18 to <45 years, the risk of CI in Q4 group was 3.73 times that of the Q1 group (<i>OR</i>=3.73, 95%<i>CI</i>: 1.18-11.80, <i>P</i>=0.025). Among patients with diabetes, the risk of CI was 2.30 times that of the Q1 group (<i>OR</i>=2.30, 95%<i>CI</i>: 1.29-4.09, <i>P</i>=0.004). <b>Conclusion:</b> Increased AIP is associated with an increased risk of CI in MHD patients, particularly in younger patients and those with diabetes.