Atherogenic Index of Plasma is Independently Associated With Microalbuminuria in Type 2 Diabetes: A Retrospective Cross-Sectional Study.

BACKGROUND: The atherogenic index of plasma (AIP) reflects the balance between proatherogenic and antiatherogenic lipoproteins and is a novel marker of atherosclerosis. OBJECTIVES: This study is aimed at investigating the association between AIP and microalbuminuria in T2DM. METHODS: This retrospective cross-sectional study included 254 patients with Type 2 diabetes mellitus divided into normoalbuminuria group and microalbuminuria group. Models were constructed for regression analysis. Restricted cubic spline was used to analyze the dose-response relationship between AIP and UACR. ROC curve was used to evaluate the discrimination power. The integrated discrimination improvement (IDI) was used to evaluate the incremental value of adding AIP to the base model. RESULTS: AIP levels were significantly higher in the microalbuminuria group than in the normal albuminuria group (0.32 ± 0.41 vs. 0.19 ± 0.33, p = 0.005). After adjusting for sex, age, blood pressure, BMI, HbA1c, and eGFR, elevated AIP remained independently associated with microalbuminuria (OR = 3.291, 95% CI: 1.411-7.676, p = 0.006). A significant dose-response trend was observed across AIP quartiles (P for trend = 0.010), with the highest quartile showing a 3.34-fold increased risk compared with the lowest (OR = 3.344, 95% CI: 1.397-8.006, p = 0.007). HbA1c (OR = 1.330) and eGFR (OR = 0.970) were also independent risk factors. The discriminative performance of AIP alone was modest, and its incremental value over conventional risk factors was limited. CONCLUSION: AIP is independently associated with microalbuminuria in T2DM with a significant dose-response relationship, suggesting its potential as an adjunctive risk marker for early DKD in primary care. However, its modest discriminative ability precludes use as a standalone screening tool. These hypothesis-generating findings require prospective validation.