Clinical Scorecard: Association of Longitudinal Changes in Plasma Atherogenic Index with the Risk of Metabolic Dysfunction-Associated Steatotic Liver Disease in a Health Examination Cohort

At a Glance

Key Highlights

• Three distinct AIP trajectory patterns identified: low-stable, moderate-stable, and high-stable.
• High-stable AIP trajectory associated with a 2.23-fold increased risk of incident MASLD after adjusting for metabolic factors.
• AIP trajectory monitoring may enable early identification and targeted prevention of MASLD.

Guideline-Based Recommendations

Diagnosis

• MASLD diagnosis requires imaging-confirmed hepatic steatosis plus at least one metabolic risk factor according to international consensus criteria.
• Use abdominal ultrasonography or biopsy for hepatic steatosis confirmation.

Management

• Monitor AIP trajectories longitudinally to identify individuals at higher risk of MASLD.
• Implement targeted prevention strategies in patients with sustained high AIP levels.

Monitoring & Follow-up

• Perform repeated AIP measurements over time to assess trajectory patterns.
• Adjust risk assessment for demographic, lifestyle, and metabolic factors including BMI and fasting glucose.

Risks

• Sustained high AIP levels independently increase risk of MASLD.
• Higher MASLD risk observed even in non-diabetic and non-hypertensive subgroups.

Patient & Prescribing Data

Adults without prior MASLD diagnosis undergoing routine health examinations with at least three AIP measurements

Longitudinal AIP trajectories provide prognostic information beyond single measurements, supporting early intervention to mitigate MASLD risk.

Clinical Best Practices

• Incorporate AIP trajectory analysis into routine metabolic risk assessments during health examinations.
• Use population-based trajectory modeling to identify patients with high-stable AIP patterns.
• Consider comprehensive metabolic evaluation and lifestyle modification counseling for patients with elevated AIP trajectories.
• Recognize that AIP is a superior predictor compared to single lipid parameters for MASLD risk.

References

• International consensus criteria for MASLD diagnosis
• Meta-analysis on AIP predicting MASLD
• Study on AIP trajectories predicting type 2 diabetes