Role of the atherogenic index of plasma in the prediction of the urinary albumin excretion and macrovascular complications in patients with type 2 diabetes

Background
Coexisting conditions with type 2 DM (T2DM), such as dyslipidemia and albuminuria, may lead to worsening of underlying diabetes and are strong risk factors for the development of cardiovascular disease.

Objectives
To identify the role of atherogenic index of plasma (AIP) as a marker for albuminuria and macrovascular complications in patients with T2DM.

Material and methods
We conducted a case-control study on 230 individuals who were classified into three groups. Group 1 (n = 80), T2DM patients who have macrovascular complications; Group 2 (n = 80), T2DM without macrovascular complications; While group 3 (n = 70) was healthy control. For all patients, laboratory investigations of lipid profile, urinary albumin execration and AIP were measured. The three study groups were compared. The relationship between AIP and urinary albumin excretion was investigated by correlation and regression analyses.

Results
AIP was significantly higher in T2DM patients with macrovascular complications compared to the other two groups (p < 0.001). There was a significant positive correlation between AIP and ACR (r = 0.740, p < 0.001). AIP could significantly predict ACR even after adjustment for the DM duration, hsCRP, HbA1c and BMI (β = 321.47; p < 0.0001). AIP could also predict macrovascular complications (unadjusted OR 547.3; p < 0 .0001), and it remains a significant predictor after adjustments (aOR 35.9; p = 0.005). For the prediction of albuminuria in patients with diabetes, at a best cut off value of AIP (> 0.137), the sensitivity and specificity were 80.51% and 90.48%, respectively.

Conclusions
High AIP was associated with an increased risk of albuminuria in patients with T2DM, which may contribute to the development of future macrovascular complications.