Clinical value of atherogenic index of plasma in predicting lean metabolic-associated fatty liver disease

Yang Qin; Cao Chunli

doi:10.3760/j.issn.1673-4777.2026.05.011

Abstract：Objective To investigate the clinical value of atherogenic index of plasma(AIP)in predicting lean metabolic-associated fatty liver disease(MAFLD).Methods Physical examinees who underwent health examination at The Affiliated Hospital of Inner Mongolia Medical University from January 2024 to January 2025 were enrolled.General and laboratory data were compared between patients with lean MAFLD(observation group)and lean healthy examinees(control group).Multivariate Logistic regression analysis was used to analyze factors associated with lean MAFLD in individuals with body mass index(BMI)＜23 kg/m2.Receiver operating charac-teristic curve was drawn to analyze the clinical value of each index in predicting lean MAFLD.The incidence of lean MAFLD was compared between high AIP group and low AIP group.Results A total of 56 patients with lean MAFLD(observation group)and 214 lean healthy examinees(control group)were screened.There were signifi-cant differences in age,gender,BMI,systolic blood pressure,diastolic blood pressure,alanine aminotransferase(ALT),aspartate aminotransferase,γ-glutamyl transferase,alkaline phosphatase,renal function,blood lipid,fasting blood glucose and AIP between the observation group and the control group(all P＜0.05).Multivariate Logistic regression analysis showed that age,gender,BMI,ALT and AIP were independent influencing factors for MAFLD in individuals with BMI＜23 kg/m2(all P＜0.05).The area under the curve(AUC)of combined prediction of lean MAFLD by BMI,ALT and AIP was 0.904,which was higher than that of single index prediction(Z=3.476,3.625,3.029;P=0.018,0.013,0.020).The incidence of lean MAFLD in high AIP group was higher than that in low AIP group[43.3％(42/97)vs 8.1％(14/173)](x2=46.863,P＜0.001).Conclusion AIP is an independent risk factor for MAFLD in individuals with BMI＜23 kg/m2.Combination of AIP,BMI and ALT has high clinical value in predicting MAFLD in individuals with BMI＜23 kg/m2.