The Association between the Atherogenic Index of Plasma and Cardiometabolic Risk Factors: A Review

Background: Metabolic syndrome (MetS) is a condition caused by a combination of cardiometabolic risk factors (CMR). MetS leads to type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), both of which place a burden on not only the patients but also the healthcare system. Diagnostic criteria for MetS vary, and there is no universal tool to detect it. Recently, many studies have found positive associations between the atherogenic index of plasma (AIP) and some CMR factors. Therefore, a comprehensive review was needed to recapitulate these studies and qualitatively estimate the likelihood of AIP being associated with CMR. We aimed to review and summarise observational data on AIP and CMR factors and verify their association.

Materials and methods: A review of observational studies was conducted by searching "atherogenic index of plasma" in PubMed, One Search, and the Cochrane library. A total of 2068 articles were screened, and 32 were included after excluding paediatric, non-human and interventional studies, and those carried out on cohorts with conditions unrelated to MetS or on lipid-lowering medication. The Newcastle-Ottawa scale was used to assess their quality.

Results: Most studies that reported high waist circumference (WC), triglycerides (TG), insulin resistance (IR) and low high-density lipoprotein cholesterol (HDL-C) concentration, also reported high AIP. Few studies investigated blood pressure (BP) and some discrepancies existed between their results.

Conclusion: AIP may be associated with WC, TG, IR, and HDL-C. It is unclear if AIP is associated with BP. The current study's results should be used to inform futureward a meta-analysis to be seen quantitatively. It is also recommended that more cohort studies stratified by gender and ethnicity be performed to ascertain if AIP can predict MetS before it manifests.