Association between atherogenic index of plasma and metabolic dysfunction-associated steatotic liver disease in Egyptian population: a case–control study

Abstract Metabolic dysfunction-associated steatotic liver disease (MASLD) is hepatic steatosis concurrent with metabolic abnormalities like obesity, insulin resistance, dyslipidemia, and hypertension. We aimed to investigate the association of atherogenic index of plasma with metabolic dysfunction-associated steatotic liver disease (MASLD). The study included 156 MASLD subjects diagnosed by B-ultrasonography having ≥ one of cardiometabolic risk factors while excluding other liver diseases and 144 healthy controls. To all participants; lipid profile, liver enzymes, serum adiponectin and basal insulin level were measured. Calculation of BMI, AIP, LDL cholesterol, Homeostatic model assessment of insulin resistance (HOMA-IR), Fatty liver index (FLI) and Fibrosis-4 (FIB-4) score were done. Receiver operating characteristic curve was drawn to discriminate diagnostic performance of variables. In patients with MASLD, AIP was significantly correlated with increased age, HOMA-IR, FLI, decreased serum adiponectin, and low HDL-C. In multivariate analysis, after adjustment of BMI, LDL-C, HOMA-IR and serum adiponectin, AIP was associated with 3.67 more risk for MASLD (highest OR). To discriminate MASLD, the AUC for AIP was 0.719 (p < 0.001) at cut-off point of > 0.372, while AUC for Combination of AIP and BMI in total MASLD group was 0.865 and for overweight and obese patients was 0.937. Atherogenic index of plasma is independently and positively associated with MASLD, more degree of hepatic steatosis, insulin resistance and low adiponectin level. Using AIP alone or in combination with BMI could alarm clinicians to further investigate for presence of MASLD in individuals at outpatient clinics.