Elevated triglyceride (TG) levels and reduced high-density lipoprotein-cholesterol (HDL-c) levels indicate lipid abnormalities, but their levels alone do not reflect the actual status of plasma atherogenicity and cardiovascular disease risk (CVD). TG and HDL-c levels directly affect the balance between plasma atherogenic and antiatherogenic factors, as well as values of the atherogenic index of plasma [AIP (logarithmically transformed ratio of TG-to-HDL-c)]. The aim of this study was to evaluate the AIP risk categories (an indicator of plasma atherogenicity) and the relationships of AIP with other atherosclerosis-related lipid parameters in patients with type 2 diabetes mellitus (T2DM) and their potential clinical utility. Standard lipid profile, AIP, and lipid hydroperoxides (LOOH) were investigated in 124 T2DM outpatients (mean age 52.7 ± 5.9 years) and 61 healthy subjects (mean age 50.9 ± 6.8 years). T2DM patients were subclassified according to the AIP risk category and glycemic control. Higher levels of AIP, LOOH, and TG and lower HDL-c (all  < 0.0001) were observed in T2DM patients than in the control group. AIP positively correlated with LOOH, non-HDL-c, and the non-HDL/HDL ratio (all  < 0.0001). The TG level was strongly correlated with the LOOH level among T2DM patients ( < 0.0001). The close association of AIP with other atherosclerosis-related lipid factors reveals an increased plasma atherogenicity. AIP risk categories indicate the actual status of plasma atherogenicity and identify subjects who are at an increased atherogenic risk and the development of CVD. In this respect, AIP has a promising future in routine clinical practice.

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