Atherogenic index of plasma (AIP)

AIP is one of the strongest predictors of cardiovascular risk, often superior to traditional cholesterol measurements. It identifies high-risk individuals who may have "normal" LDL cholesterol but dangerous particle characteristics. Elevated AIP indicates a predominance of small, dense LDL particles that penetrate arterial walls more easily, remain in circulation longer, and are more susceptible to oxidation. The index strongly correlates with insulin resistance, metabolic syndrome, and coronary artery disease risk.

Unlike simple cholesterol ratios, AIP's logarithmic scale provides enhanced sensitivity for detecting atherogenic profiles, making it particularly valuable for identifying hidden cardiovascular risk in diabetes, metabolic syndrome, and seemingly healthy individuals with normal standard lipid panels.

Most adults benefit from checking AIP yearly as part of a lipid panel. After a meaningful change in diet, body composition, or medication, retest at 8 to 12 weeks.

At baseline / for screening: Once every 12 months from age 30, alongside the rest of your lipid panel. Earlier and more frequent if you have a family history of early cardiovascular disease, elevated Lp(a), or known cardiovascular risk factors.

When monitoring an intervention or change: Retest 8 to 12 weeks after a sustained lifestyle change, such as reducing refined carbs and alcohol, meaningful weight loss, or a new aerobic routine. Both inputs (triglycerides and HDL) need time to settle at a new steady state. After starting lipid-lowering medication, the same window captures meaningful change. AIP is most useful as a trend across multiple readings.