Year: 2026 | Month: January-March | Volume: 11 | Issue: 1 | Pages: 73-78
DOI: https://doi.org/10.52403/ijshr.20260108
Atherogenic Index of Serum and Non-HDL Cholesterol as Predictors of Cardiometabolic Risk in Type 2 Diabetes Mellitus
Sreeja Shanker J1, Vibha C2, Parvathi M3
1Assistant Professor, Department of Biochemistry, Government Medical College (IIMS), Palakkad
2Professor, Department of Biochemistry, Bangalore Medical College & Research Institute, Bangalore
3Assistant Professor, Department of General Medicine, Bangalore Medical College & Research Institute, Bangalore.
Corresponding Author: Dr Sreeja Shanker J
ABSTRACT
Background: Type 2 diabetes mellitus (T2DM) is strongly associated with increased cardiovascular risk. While conventional lipid measurements such as LDL-cholesterol (LDL-C) are well-established markers of atherosclerosis, they do not fully explain the excess cardiovascular disease (CVD) risk observed in T2DM. Non-HDL-cholesterol (non-HDL-C) and composite lipid ratios like Atherogenic Index of Plasma (AIP), Castelli Risk Index-I (CRI-I), Castelli Risk Index-II (CRI-II), Atherogenic Coefficient (AC), and triglyceride-to-HDL ratio (TG/HDL) may better reflect the burden of atherogenic lipoproteins.
Objective: To evaluate non-HDL-C and selected atherogenic indices in adults with T2DM and compare them with healthy controls.
Methods: A case control study including 40 T2DM patients and 40 age-matched controls. Fasting glucose, HbA1c, and lipid parameters were measured. Non-HDL-C was calculated as TC−HDL. Derived indices included AIP=log10(TG/HDL), CRI-I=TC/HDL, CRI-II=LDL/HDL, AC=(TC−HDL)/HDL, and TG/HDL ratio. Independent t-tests were applied.
Results: T2DM subjects had significantly higher TC (202.8±33.1 mg/dL), TG (168.7±71.4 mg/dL), LDL-C (134.7±35.9 mg/dL), and lower HDL-C (33.8±5.8 mg/dL) than controls (p<0.001). Non-HDL-C was markedly elevated (168.9±34.0 vs. 102.9±32.3 mg/dL, p=1.6×10⁻¹³). Atherogenic indices were significantly higher in T2DM: AIP (0.66±0.23 vs. 0.40±0.16), CRI-I (6.20±1.56 vs. 3.41±0.90), CRI-II (4.17±1.49 vs. 2.47±0.68), AC (5.20±1.56 vs. 2.41±0.90), and TG/HDL (5.11±2.14 vs. 2.69±1.07).
Conclusion: Non-HDL-C and atherogenic indices were significantly higher in T2DM and reflect the atherogenic burden associated with diabetic dyslipidaemia. Incorporating these indices into routine assessment may enhance early detection of CVD risk.
Keywords: Non-HDL cholesterol, T2DM, AIP, Castelli Index, atherogenic indices, dyslipidaemia.