# Exploring the Relationship Between Atherogenic Index of Plasma, Body Mass Index, and Fatty Liver in Obese Patients

## TL;DR

This study shows that higher BMI and atherogenic index of plasma (AIP) are linked to more severe fatty liver in obese individuals, suggesting they can be used for early detection.

## Contribution

The study demonstrates the utility of BMI and AIP as cost-effective screening tools for fatty liver severity in obese patients.

## Key findings

- High AIP values were found in 61.5% of patients, indicating elevated atherogenic risk.
- AIP levels and BMI increased significantly with the severity of fatty liver (p<0.05).
- Moderate to severe fatty liver was observed in 65.4% of participants.

## Abstract

Objective: This study aimed to estimate the body mass index (BMI) and the atherogenic index of plasma (AIP) in obese individuals, evaluate the grade of fatty liver using abdominal ultrasound, and assess the relationships among AIP, BMI, and fatty liver severity.

Methodology: This hospital-based cross-sectional study was conducted at R.L. Jalappa Hospital and Research Centre in Kolar to examine the association between three key metabolic parameters - AIP, BMI, and ultrasound-diagnosed fatty liver - in obese individuals. The study was carried out over three months from December 2024 to February 2025 and included 26 adults with a BMI greater than 25 kg/m² based on the Asian cut-off values. Participants underwent BMI calculation, fasting lipid profile testing, and abdominal ultrasound for fatty liver grading. Individuals with chronic liver disease, alcohol use, or conditions affecting lipid metabolism were excluded. AIP was calculated using the established logarithmic formula: log (triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C)). Statistical analysis was performed using IBM SPSS Statistics v22 (IBM Corp., Armonk, USA), with a p-value less than 0.05 considered statistically significant.

Results: In this study, 18 (69.2%) participants were classified as obese (BMI ≥30 kg/m²), and the most common fatty liver grade was Grade II, observed in 11 (42.3%) patients. A total of 17 (65.4%) patients had moderate to severe fatty liver (Grades II and III). High AIP values (>0.21) were observed in 16 (61.5%) patients, with 23 (88.4%) showing elevated atherogenic risk. AIP levels significantly increased with fatty liver severity (p<0.05), and the mean BMI also rose progressively across fatty liver grades (p<0.05). These findings highlight strong associations between BMI, AIP, and fatty liver severity in obese individuals.

Conclusion: The results demonstrated a clear positive correlation between both BMI and AIP values and the severity of fatty liver disease in the obese population. These findings suggest that BMI and AIP are practical, cost-effective screening tools for the early detection of metabolic dysfunction-associated steatotic liver disease (MASLD). Their utility is particularly relevant in clinical settings with limited access to advanced diagnostic modalities. The study supports the integration of BMI and AIP into routine screening protocols to guide early intervention and mitigate the long-term health burden of non-alcoholic fatty liver disease (NAFLD).