Search Results (7,186)

HIV infection can promote persistent immune activation and endothelial dysfunction, contributing to atherosclerosis. Carotid intima–media thickness (cIMT) is an established marker of subclinical atherosclerosis. We evaluated the association between cIMT severity and two routinely available markers of immune dysregulation (CD4/CD8 ratio and nadir CD4+ cell count) in people living with HIV (PLWH). We conducted an Italian multicenter cross-sectional study including 1148 PLWH who underwent carotid color Doppler ultrasound. We classified cIMT as ≤0.9, 1.0–1.4, or >1.4 mm and analyzed these categories using multinomial logistic regression, reporting adjusted odds ratios (aORs) with 95% confidence intervals (CIs). We adjusted models for age, sex, BMI, HIV acquisition risk factor, hypertension, diabetes, dyslipidemia/statin use, triglycerides, integrase inhibitor use, and ART duration. cIMT was ≤0.9 mm in 615 (53.6%) participants, 1.0–1.4 mm in 379 (33.0%), and >1.4 mm in 154 (13.4%). Using nadir CD4+ ≥ 200 cells/µL and CD4/CD8 ≥1.0 as reference, PLWH with nadir CD4+ < 200 and CD4/CD8 ≥ 1.0 had higher odds of cIMT 1.0–1.4 mm (aOR 1.66, 95% CI 1.02–2.69) and >1.4 mm (aOR 3.45, 95% CI 1.68–7.07). In conclusion, CD4+ nadir and this combined pattern were associated with greater cIMT severity, supporting a role for immune dysregulation in subclinical atherosclerosis. Full article

Dietary metabolizable energy (ME) and crude protein (CP) are key determinants of production efficiency in geese; however, their combined effects during the rapid growth phase are not well defined. A total of 240 male goslings were assigned to four treatments in a 2 × 2 factorial arrangement, with six replicates per treatment and 10 birds per replicate. We used a 2 × 2 factorial design to evaluate two ME levels (11.20 vs. 11.65 MJ/kg) and two CP levels (16% vs. 14%) in goslings from 35 to 63 days of age. Growth performance, carcass traits, meat quality, serum biochemical indices, and instrumental taste attributes were measured. Increasing ME increased body weight at day 63 and average daily gain (p < 0.05), whereas average daily feed intake and feed-to-gain ratio were not affected. Most carcass traits were unchanged; however, leg muscle percentage differed between ME levels (p < 0.01) and was higher in the 11.20 MJ/kg group. Meat color responses were muscle- and time-dependent: breast b* at 45 min postmortem was affected by ME and CP (p < 0.001), and leg color traits at 45 min exhibited significant ME × CP interactions (p < 0.05). Postmortem pH, water-holding capacity, and shear force were largely unaffected by dietary treatments. Serum glucose showed a significant ME × CP interaction (p = 0.001), and triglyceride concentration was influenced by both ME and CP (p < 0.01), with lower values observed at higher ME and lower CP. Instrumental taste attributes did not differ among treatments (p > 0.05). In conclusion, modest changes in dietary ME and CP modulated growth and selected carcass, color, and metabolic traits without compromising key technological meat-quality parameters. These results indicate that, during 35–63 days of age, the higher-ME diet (11.65 MJ/kg) combined with a moderate CP reduction to 14% can be considered a feasible formulation option under the conditions of this study. Full article

Dendroctonus armandi is a major primary pest of Chinese white pine in the Qinling–Bashan forest region. By feeding on the phloem and vectoring symbiotic fungi that cause blue stain in the sapwood, it drives rapid decline and mortality of host trees. As a key wood-boring forest insect, its outbreaks are closely linked to adaptive strategies in energy metabolism. Adipokinetic hormone (AKH) is a highly conserved insect neuropeptide and plays a major role in regulating energy metabolism. This study aimed to determine how the AKH gene regulates energy use in D. armandi under different stress conditions. We cloned the DaAKH gene and its receptor gene, DaAKHR, from D. armandi. DaAKH and DaAKHR showed the highest expression in emerged adults and the lowest levels in pupae. In larvae and in adult males and females, DaAKH transcripts were predominantly expressed in the head, whereas DaAKHR was enriched in the fat body. Under starvation and cold stress, DaAKH and DaAKHR expression were significantly upregulated; under heat stress, expression first increased and then decreased. Across stress treatments, RNAi significantly downregulated DaAKH and DaAKHR expression in D. armandi. Under starvation, RNAi reduced mortality, lowered lipid metabolism, and led to lipid accumulation, thereby mitigating premature energy depletion and starvation-induced death. By contrast, under heat and cold stress, RNAi significantly increased mortality, significantly reduced triglyceride and glycogen consumption, and suppressed metabolism. These results indicate that DaAKH and DaAKHR regulate energy allocation under starvation stress and help maintain adaptive capacity under temperature stress in D. armandi. By tuning energy metabolism, DaAKH and DaAKHR help resist environmental stress and maintain reproduction and population size. This study advances understanding of the physiological responses and molecular mechanisms of D. armandi under stress conditions and provides a new avenue for metabolism-targeted control. Full article

Background/Objectives: Early detection of cardiometabolic irregularities is crucial for averting cardiovascular illness; however, demographic cohorts that consistently engage with healthcare systems like habitual blood donors are inadequately leveraged for metabolic monitoring. Methods: This study performed lipid profiling and cardiovascular risk assessment among blood donors identified with visually lipemic plasma during routine screening, in order to explore metabolic variability within this selected donor subgroup. Of 13,818 screened donors, 160 with lipemic plasma were included, and multivariable and machine-learning analyses were restricted to 90 donors with complete clinical data. Results: We observed substantial variability in triglyceride levels, with males displaying higher and more dispersed values. Correlation analysis indicated that triglycerides were associated with BMI and composite cardiovascular risk metrics, while age was the strongest contributor to the calculated 10-year cardiovascular risk score. Using a Random Forest classifier, elevated triglyceride levels were predicted with an AUC of 0.86; however, given the limited sample size, this analysis should be interpreted as exploratory and proof-of-concept in nature. Conclusions: In this selected subgroup of donors with lipemic plasma, clinically relevant hypertriglyceridemia was frequently observed. These findings suggest that routine donor data may provide opportunities for targeted metabolic monitoring, although the results cannot be generalized to the broader blood donor population. Further studies in larger and more representative cohorts are warranted. Full article

Background and Aims: Injectable lipid emulsions are an integral component of parenteral nutrition, providing energy as well as essential fatty acids. However, conventional soybean oil–based emulsions, which are rich in omega-6 fatty acids, are associated with a risk of exacerbating pro-inflammatory responses and immunosuppression, which is of particular importance in critically ill patients. The aim of this review is to present the significance of the composition of modern injectable lipid emulsions, with particular emphasis on emulsions containing fish oil as a source of omega-3 fatty acids (EPA and DHA), and to discuss their potential clinical benefits in selected critical conditions. Methods: This narrative review discusses the rationale for modern mixed-oil ILE, with a focus on fish oil as a source of EPA and DHA, and summarizes potential clinical benefits in selected critical care settings. Results: Modern injectable lipid emulsions combine long-chain triglycerides derived from soybean oil (omega-6), MCTs, olive oil (omega-9), and fish oil (omega-3). Adjusting the supply of individual fractions affects cell membrane structure, signaling pathways, gene expression, and the profile of lipid mediators produced, including specialized pro-resolving mediators (SPMs). ESPEN guidelines and international recommendations emphasize the need to use lipids in parenteral nutrition, preferring mixed-oil ILE supplemented with fish oil. The cited meta-analyses and clinical studies indicate that omega-3-containing emulsions may reduce the risk of infections and sepsis; shorten hospital stay, ICU length of stay, and duration of mechanical ventilation in patients with sepsis; as well as improve outcomes in acute pancreatitis; lower the risk of delirium; and reduce the incidence of delayed gastric emptying. Conclusions: Available data support the use of mixed-oil ILE supplemented with fish oil in the parenteral nutrition of critically ill patients as a strategy with immunomodulatory and pro-resolving potential that may translate into improved clinical outcomes. However, further well-designed randomized trials are needed to optimize dosing and administration regimens. Full article

Sea buckthorn pericarp pomace, a major by-product of juice processing, represents a promising food-grade source of bioactive flavonoids. This study investigated the hypolipidemic effects and underlying mechanisms of total flavonoids extracted from Sea buckthorn pericarp pomace (TFSP) in mice with high-fat diet (HFD)-induced hyperlipidemia. TFSP intervention significantly suppressed body weight gain and improved serum lipid profiles by reducing total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), while increasing high-density lipoprotein cholesterol (HDL-C). Hepatic lipid accumulation and injury were alleviated, accompanied by enhanced activities of antioxidant enzymes (SOD, CAT, GSH-Px) and reduced oxidative stress markers. At the molecular level, TFSP downregulated key lipogenic proteins—including ACC and FAS—and upregulated markers of fatty acid oxidation and triglyceride hydrolysis—namely CPT-1α, PPARα, and ATGL. Moreover, TFSP restored HFD-induced gut microbiota dysbiosis, increased the relative abundance of beneficial genera such as Akkermansia, and decreased that of potentially harmful taxa including Allobaculum. These findings demonstrate that TFSP—a value-added food processing by-product—ameliorates hyperlipidemia through coordinated regulation of hepatic lipid metabolism and gut microbial composition, supporting its potential application as a natural, food-derived ingredient in lipid-lowering functional foods. Full article

Olive pomace, a byproduct of olive oil production, is a rich source of bioactive phenolic compounds with potential health benefits. This study aimed to characterize the chemical composition and evaluate the metabolic effects of a subcritical water extract from California olive pomace (SWE COP) obtained from Arbequina olives. The extract was mainly composed of carbohydrates (72.81%) and contained 66.62 ± 1.22 mg gallic acid equivalents/g of phenolics, with 3,4-DHPEA-EDA, hydroxytyrosol, and verbascoside identified as the predominant compounds. Male C57BL/6N mice were fed a standard diet (SD; n = 7), a high-fat and high-sugar diet (HFSD; n = 7), which was used to induce features of diet-associated metabolic syndrome, or an HFSD supplemented with 3% (w/w) SWE COP (n = 7) for 16 weeks. Supplementation with SWE COP significantly reduced plasma triglycerides and increased HDL cholesterol levels compared with the HFSD group. Moreover, SWE COP improved glucose tolerance, enhanced insulin sensitivity, and reduced mesenteric and epididymal adiposity. Histological analysis showed that SWE COP alleviated hepatic steatosis and lowered the NAFLD activity score. These findings demonstrate that phenolic-rich SWE COP exerts beneficial effects on glucose and lipid metabolism and reduces liver fat accumulation in diet-induced obese mice. Overall, SWE COP represents a promising functional ingredient derived from olive industry byproducts for mitigating metabolic dysfunctions associated with obesity. Full article

Background/Objectives: The global increase in metabolic dysfunction-associated steatotic liver disease underscores the need for accessible and reliable markers to assess hepatic steatosis. The triglyceride–glucose (TyG) index, derived from fasting plasma glucose and triglyceride levels, has emerged as a practical surrogate marker of insulin resistance and has been increasingly associated with metabolic liver involvement. This study aimed to evaluate the relationship between the TyG index and the severity of hepatic steatosis assessed by ultrasonography. Methods: This retrospective cross-sectional study included 480 adult patients without a prior diagnosis of diabetes mellitus or hypertension who underwent fasting laboratory testing and abdominal ultrasonography between January 2024 and May 2025. Fasting plasma glucose and triglyceride levels were obtained on the same day as ultrasonographic evaluation. Hepatic steatosis was assessed by a single experienced radiologist using standardized ultrasonographic criteria, and patients were categorized into three groups according to steatosis grade (grade 0, grade 1, and grade 2–3; n = 160 for each group). Demographic data and laboratory parameters, including glucose, triglycerides, HbA1c, platelet count, neutrophils, lymphocytes, monocytes, ALT, AST, and total cholesterol levels, were recorded. The TyG index was calculated using the formula: TyG = ln[(fasting triglycerides × fasting glucose)/2]. Results: A total of 480 patients (30.6% male) were included in the analysis. Mean fasting glucose, triglyceride, and TyG index values were 94.20 ± 11.15 mg/dL, 146.91 ± 83.94 mg/dL, and 8.70 ± 0.55, respectively. Metabolic and inflammatory parameters increased significantly with advancing steatosis grades (all p < 0.05). The TyG index demonstrated a clear stepwise increase from grade 0 (8.29 ± 0.42) to grade 1 (8.74 ± 0.42) and grade 2–3 steatosis (9.07 ± 0.49) (p < 0.001), with all pairwise comparisons remaining statistically significant. Receiver operating characteristic (ROC) analysis showed good discriminative performance of the TyG index for hepatic steatosis (AUC = 0.829), and an optimal cutoff value of 7.90 was identified using the Youden index, yielding high sensitivity for detection. In multivariable logistic regression analysis, the TyG index remained the strongest independent predictor of hepatic steatosis (adjusted OR 11.41, 95% CI 6.10–21.34; p < 0.001). Conclusions: The TyG index increased progressively with the severity of hepatic steatosis and showed strong associations with metabolic and inflammatory parameters. These findings support the TyG index as a simple and accessible marker reflecting metabolic dysfunction and hepatic steatosis, with potential value for early risk stratification in clinical practice. Full article

Background and Clinical Significance: Ventriculoperitoneal (VP) shunting remains the standard definitive treatment for progressive neonatal obstructive hydrocephalus. Congenital chylous ascites is an uncommon neonatal condition, most often related to developmental lymphatic abnormalities. The concurrence of hydrocephalus requiring VP diversion with congenital chylous ascites is exceptionally rare and may first become apparent during abdominal access for shunt placement. Awareness of this possibility is clinically important because milky peritoneal fluid at shunt surgery can mimic gastrointestinal injury, and persistent postoperative abdominal fluid collections may be misattributed to shunt-related complications. Case Presentation: A late-preterm female infant (36 weeks’ gestation; birth weight 2.3 kg) presented with congenital hydrocephalus. Cranial ultrasonography was consistent with isolated aqueductal stenosis. Preoperative abdominal ultrasonography demonstrated mild ascites. On 27 May 2025, a VP shunt was placed for obstructive hydrocephalus. Upon entering the peritoneal cavity, milky-white fluid was encountered, prompting concern for bowel injury; however, careful exploration showed no gastrointestinal perforation. Ascitic fluid analysis revealed markedly elevated triglycerides (2300 mg/dL), confirming chylous ascites. The VP shunt was completed without an intraoperative complication. During follow-up, the infant showed appropriate growth (weight 3.0 kg; length 50 cm), while ascites persisted, and she was referred for multidisciplinary evaluation and management. Conclusions: This case highlights an exceptionally rare association of congenital chylous ascites with isolated aqueductal stenosis, identified incidentally during VP shunt insertion. Prompt intraoperative recognition, biochemical confirmation, and coordinated follow-up are essential to distinguish congenital chylous ascites from shunt-related abdominal fluid collections and to guide appropriate multidisciplinary care. Full article

Background: Insulin resistance is defined as reduced tissue responsiveness to insulin-mediated glucose actions. Gold standard methods like hyperinsulinemic-euglycemic clamp and hyperglycemic clamps are costly and rarely used in large epidemiological studies. The aim was to evaluate the best performing machine learning algorithm for insulin resistance predictions in Brazilian adolescents. Methods: We used data from 37,454 Brazilian adolescents from 12 to 17 years, sampled from the Study of Cardiovascular Risk Factors in Adolescents (2013–2014). Covariates included other cardiovascular risk factors. We evaluate seven machine learning models stratifying the subset by sex. The performance of the models was assessed by area under the curve (AUC), calibration curves and decision curve analysis (DCA). Finally, we adopted the SHAP approach to assess the importance of each variable to the best performing ML model. Results: The Logistic Regression model presented the best AUC value (AUC = 0.8 for boys and girls). The best performing ML models had higher calibration in girls than in boys. The DCA curves showed prevalence of almost equal values for girls and for boys. The most important clinical predictors for both sexes were waist circumference, triglycerides and age. Conclusions: Logistic Regression proved to be the best clinical prediction model comparable to complex models. Further studies are needed in more diverse populations. Full article

The present study investigated the impact of dietary papaya leaf meal (PLM) at three inclusion levels (0%, 6%, and 12%) with or without multi-enzyme supplementation (0.5 g/kg diet) on growth performance, nutrient digestibility, carcass characteristics, serum biochemistry, lipid profile, and antioxidant status in Arbor Acres broiler chickens. A total of 240 one-day-old chicks were allocated to six treatments in a 3 × 2 factorial arrangement for 42 days. Enzyme supplementation significantly improved body weight gain, feed conversion ratio, and nutrient efficiency (p < 0.001), while moderate PLM inclusion (6%) supported optimal performance. Digestibility of crude fiber and ether extract was enhanced by enzymes (p < 0.05), with a notable PLM × enzyme interaction for fiber digestibility. Carcass yield was unaffected, but enzyme supplementation increased dressing percentage and reduced abdominal fat. Serum biochemistry remained largely unchanged, except for elevated AST at 12% PLM (p < 0.01). Lipid profile improved with enzyme supplementation, reducing total cholesterol, triglycerides, and LDL while increasing HDL (p < 0.05). Enzyme supplementation significantly increased SOD and CAT activities (p < 0.001), whereas TAC responses were inconsistent across treatments. Lipid peroxidation (MDA) increased at 12% PLM, indicating a potential oxidative imbalance at higher inclusion levels. In conclusion, multi-enzyme supplementation was the primary driver of growth performance and nutrient utilization improvements, while moderate PLM inclusion (6%) exerted supportive and synergistic effects without compromising carcass traits. Full article

Kidney transplantation (KTx) corrects many uremia-related metabolic disturbances; however, dyslipidemia remains common in kidney transplant recipients and contributes to persistent cardiovascular risk. Lipoprotein(a) [Lp(a)] is a largely genetically determined proatherogenic lipoprotein that increases in advanced chronic kidney disease (CKD) and may decrease after restoration of renal function. Autotaxin (ATX), an enzyme involved in proinflammatory lipid signaling through the ATX–lysophosphatidic acid axis, has also been implicated in cardiovascular pathology, but its early post-transplant dynamics remain poorly characterized. In addition to quantitative lipid abnormalities, CKD is associated with high-density lipoprotein (HDL) dysfunction and reduced paraoxonase-1 (PON-1) activity; however, data on early post-transplant changes in PON-1 activity are limited. In this prospective observational study, lipid profile parameters, Lp(a) concentration, ATX activity, and PON-1 activity were assessed in 55 Caucasian patients with CKD stage 5, most of whom were dialysis-dependent, before and 2–3 weeks after KTx. All recipients received tacrolimus-based maintenance immunosuppression with corticosteroids and mycophenolate mofetil. After KTx, Lp(a) levels decreased by a median of 21% and ATX activity by 28% (both p < 0.001). Lp(a) and ATX showed no cross-sectional or longitudinal association either before or after transplantation, and their percentage changes were not correlated. In contrast, conventional lipid fractions increased significantly, including total cholesterol (+22%), LDL cholesterol (+27%), HDL cholesterol (+24%), and triglycerides (+55%) (all p < 0.001). PON-1 activity increased by approximately 13% after KTx (p < 0.001), and its percentage change correlated positively with the increase in HDL cholesterol. In exploratory analyses, the magnitude of Lp(a) reduction was associated with early graft function: patients with eGFR <45 mL/min/1.73 m² exhibited a significantly smaller decline in Lp(a) than those with better graft function (−4.8% vs. −26.7%, p = 0.009). Multivariable analysis showed that demographic characteristics, body mass index, tacrolimus exposure, and post-transplant eGFR did not independently predict the magnitude of Lp(a) reduction. Tacrolimus trough concentrations and cumulative corticosteroid exposure were not associated with lipid parameters or their changes, except for a single subgroup difference in PON-1 activity of uncertain clinical significance. In the early period after KTx under tacrolimus-based immunosuppression, Lp(a) concentration and ATX activity decrease, whereas conventional lipid fractions increase and PON-1 activity improves. These changes were not associated with tacrolimus exposure or cumulative corticosteroid dose. The reduction in Lp(a) was associated with early graft function in exploratory analyses, suggesting that recovery of renal function may contribute to early post-transplant Lp(a) dynamics; however, no independent causal relationship was established, and the findings should be interpreted cautiously given the limited sample size and exploratory design. The clinical significance of these changes for long-term cardiovascular and graft outcomes requires further investigation. Full article

Background/Objectives: The development of obesity is not only related to excessive adipose tissue accumulation but also involves complex inter-organ signaling pathways linking skeletal muscle and neuroendocrine systems. The present study aimed to evaluate circulating levels of myonectin (CTRP15), a skeletal muscle–derived metabolic regulator, and oxytocin, a neuropeptide with anorexigenic properties, in children with obesity. In addition, we examined the potential associations of these biomarkers with insulin resistance and metabolic risk indicators. Methods: This cross-sectional study included 53 children with obesity (body mass index standard deviation score [BMI-SDS] > 2) and 37 healthy children with normal body weight serving as controls. Anthropometric parameters, fasting glucose, insulin, lipid profile, and the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) index were assessed in all participants. Circulating concentrations of myonectin and oxytocin were measured and compared between groups, and correlations with metabolic variables were explored. Results: Children with obesity exhibited a less favorable metabolic profile characterized by higher HOMA-IR values, hyperinsulinemia, and elevated triglyceride levels. Serum myonectin concentrations were significantly lower in the obesity group compared with controls (4.01 ± 3.66 vs. 8.35 ± 12.00 ng/mL; p = 0.019). In contrast, circulating oxytocin levels were significantly higher among children with obesity (median [IQR] 156.2 [83.9–754.9] vs. 141.7 [47.7–221.5] pg/mL; p = 0.044). Neither hormone demonstrated a significant linear relationship with age, BMI-SDS, or HOMA-IR. Conclusions: Our findings indicate that childhood obesity is associated with reduced circulating myonectin levels and increased oxytocin concentrations. These observations suggest potential alterations in both muscle-derived metabolic signaling and neuroendocrine regulation in pediatric obesity. However, due to the cross-sectional design of the present study, causal relationships cannot be established. Full article

Objectives: This study aimed to investigate the associations between serum lipid biomarkers and pulse wave analysis (PWA) variables in patients at high and very high cardiovascular risk, with particular emphasis on age-related differences. Methods: Seventy-six patients at high or very high cardiovascular risk were enrolled and stratified into middle-aged (Group 1) and elderly (Group 2). All participants underwent PWA, and multiple serum lipid biomarkers were measured, including composite lipid indices. Results: In both age groups, PWA parameters showed significant correlations with serum lipid biomarkers. Systolic blood pressure (SBP) was an independent determinant of the lipid balance index (LBI), while pulse wave velocity (PWV) and SBP were independent determinants of the triglyceride–glucose (TyG) index. PWV correlated with age in both groups and was higher in Group 2 for comparable blood pressure values. In middle-aged patients, diastolic blood pressure (DBP) showed significant, independent associations with triglycerides and TyG, indicating a close link between peripheral vascular resistance and metabolic dysfunction in earlier stages of cardiovascular risk. In elderly patients, SBP and pulse pressure were predominantly associated with lipid-derived indices, reflecting the increasing contribution of large-artery stiffness and lipid-driven vascular remodeling with advancing age. Systematic Coronary Risk Estimation 2 (SCORE2) correlated significantly with PWV, the lipid index (LI), and the LBI. Conclusions: Serum lipid biomarkers and PWA-derived hemodynamic variables exhibit a significant, age-dependent interplay in patients with high and very high cardiovascular risk. These findings underscore the importance of age-specific evaluation of lipid–hemodynamic interactions to improve early identification and targeted management of high-risk individuals. Full article

Background/Objectives: Prediabetes is a metabolic condition involving various phenotypes of glucose metabolism. Prediabetes increases the risk of heart disease, among other conditions. Hence, we employed machine learning tools to characterize phenotypes associated with cardiovascular disease using routine laboratory biomarkers. Methods: We processed laboratory records of over 1,000,000 de-identified individuals, resulting in a sample of 3024 individuals classified as prediabetic (fasting blood glucose 100–125 mg/dL combined with HbA1c 5.7–6.4%). Lipid profile parameters (total cholesterol [TC], HDL-C, LDL-C, and triglycerides) and associated indices (atherogenic index of plasma, Log₁₀(TG/HDL-C), triglyceride–glucose index [TyG], TC/HDL-C, and LDL-C/HDL-C, among others) were analyzed using the k-means algorithm. Two groups emerged based on biomarker concentrations, a pro-atherogenic cluster (P-AC; n = 1113) and a less-atherogenic cluster (L-AC; n = 1911) for cardiovascular disease. Results: We assessed the performance of biomarkers in the P-AC and L-AC clusters using a receiver operating characteristic curve. Triglycerides (area under the curve [AUC] 0.977), AIP (AUC 0.978), and triglyceride–glucose index (AUC 0.974) showed sensitivity and specificity >90%. The TC/HDL-C (AUC 0.903) and LDL-C/HDL-C (AUC 0.865) indices also performed well, with sensitivity and specificity of 80%. Binomial logistic regression applied to the groups generated by k-means using the biomarkers AIP and LDL-C/HDL-C showed an AUC of 0.984 and accuracy above 93%. Conclusions: The k-means algorithm enabled the identification of a P-AC for cardiovascular disease among prediabetics using cost-effective laboratory biomarkers that are widely accessible in laboratories. Individuals classified as P-AC may benefit from differentiated treatment to minimize this factor. Full article