Association and Diagnostic Performance of the Atherogenic Index of Plasma and Carotid Intima-Media Thickness in Non-alcoholic Fatty Liver Disease: A Cross-Sectional Study

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD), recently termed metabolic dysfunction-associated steatotic liver disease (MASLD), is increasingly recognized as a multisystem metabolic disorder associated with significantly elevated risk of cardiovascular disease (CVD). Atherogenic Index of Plasma (AIP) and carotid intima-media thickness (CIMT) are considered as surrogate markers of atherosclerotic cardiovascular disease (ASCVD). As CVD is the common link between NAFLD and parameters, such as AIP and CIMT, the present study was conducted to determine any association and discriminatory ability of AIP and CIMT in relation to NAFLD severity. METHODS: This was a hospital-based cross-sectional study, conducted in the Department of General Medicine in collaboration with the Department of Radiodiagnosis at Kalinga Institute of Medical Sciences (KIMS), KIIT, Deemed to be University, Bhubaneswar, Odisha, India, from March 2023 to February 2025. A total of 151 participants (75 NAFLD cases and 76 controls) were enrolled during the study. NAFLD was graded by ultrasonography. AIP was calculated as log₁₀(triglyceride (TG)/high-density lipoprotein cholesterol (HDL)-C), Fatty Liver Index (FLI) was derived using the Bedogni formula, and CIMT was measured bilaterally using B-mode ultrasonography. In addition, correlation, multivariate regression, and receiver operating characteristic (ROC) curve analyses were performed. RESULTS: Among 151 participants (75 NAFLD cases and 76 controls), patients with NAFLD demonstrated significantly higher TG and lower HDL-C levels (p