AIP Explained
The Atherogenic Index of Plasma — a logarithmic marker that predicts cardiovascular risk and LDL particle size from standard lipid values.
Who is this especially useful for?
- ✓People with elevated triglycerides or low HDL
- ✓Those wanting to assess LDL particle size without advanced tests
- ✓Individuals optimizing lipid profiles on low-carb or keto diets
- ✓Anyone tracking cardiovascular risk from routine labs
AIP uses standard lipid panel values to estimate atherogenic risk.
Standard lipid panels focus on individual cholesterol numbers. But researchers have found that the relationship between your triglycerides and HDL cholesterol may be even more important than either value alone.
The Atherogenic Index of Plasma (AIP) captures this relationship using a logarithmic calculation. It reflects the balance of "bad" and "good" lipoproteins in your blood — and strongly predicts cardiovascular risk, arterial plaque formation, and even metabolic syndrome.
Where to find your Triglycerides and HDL
Fast 8-12 hours before testing for accurate triglyceride readings
What is AIP?
AIP stands for Atherogenic Index of Plasma. It was developed by researchers Dobiásová and Frohlich in 2001 as a way to better predict cardiovascular risk from standard lipid values.
The term "atherogenic" refers to the process of arterial plaque formation (atherosclerosis). High AIP indicates a lipid profile that promotes plaque buildup in arteries. Low AIP suggests a more protective lipid pattern.
AIP has a strong correlation with LDL particle size — a key factor in cardiovascular risk. Higher AIP typically means smaller, denser (more dangerous) LDL particles.
The Formula
AIP = log₁₀(Triglycerides / HDL-C)
Both values in the same units (mg/dL or mmol/L) • Our calculator handles conversions
Example Calculation
Triglycerides: 150 mg/dL
HDL-C: 50 mg/dL
Ratio: 150 / 50 = 3.0
AIP: log₁₀(3.0) = 0.48 → High Risk
Why Logarithms?
The logarithmic transformation normalizes the distribution of lipid ratios and creates a more linear relationship with cardiovascular outcomes. This makes AIP especially useful for detecting risk across a wide range of lipid values.
r = 0.75
LDL Size Correlation
Strong correlation with LDL particle size
Dobiásová & Frohlich, 2001
2001
Developed
Research-based formula developed in Czechoslovakia
Clinical Biochemistry
Better
Than LDL-C Alone
Predicts CVD mortality better than individual lipids
Edwards et al., 2017
What Research Shows
The 2017 Edwards study in Mayo Clinic Proceedings found that AIP and TG/HDL ratio predict mortality risk better than individual cholesterol values. AIP's logarithmic scale provides normalized distribution that improves statistical reliability across diverse populations.
23,000+ participants in NHANES analysis
How Different Paradigms Interpret AIP
Different medical approaches interpret the same AIP values through different lenses:
Standard Medical View
Thresholds: < 0.11 low risk, 0.11-0.21 intermediate, > 0.21 high risk
AIP is a useful research tool, but clinical focus remains on LDL-C. High AIP may warrant lifestyle discussion and lipid monitoring.
Consider LDL-lowering therapy if LDL-C is elevated regardless of AIP.
Research Consensus View
Thresholds: Target < 0.10 for optimal cardiovascular protection
AIP reflects the atherogenic nature of your lipid profile. Lower is better for long-term arterial health and healthy aging.
Optimize through Mediterranean diet, omega-3s, and regular aerobic exercise.
Metabolic Focus View
Thresholds: < 0.1 excellent, > 0.24 indicates metabolic dysfunction
High AIP signals small, dense LDL and metabolic syndrome. Often driven by hyperinsulinemia and carbohydrate excess.
Carbohydrate restriction rapidly improves TG/HDL balance and AIP.
What's a Good AIP Score?
| AIP | Category | What It Means |
|---|---|---|
| < 0.11 | Low Risk | Protective lipid profile. Associated with large, buoyant LDL particles. Excellent cardiovascular health. |
| 0.11 – 0.21 | Intermediate | Moderate cardiovascular risk. Consider lifestyle optimization. |
| > 0.21 | High Risk | Atherogenic lipid profile. Associated with small, dense LDL particles. Increased CVD risk. |
The LDL Particle Size Connection
AIP is strongly correlated with LDL particle size. This is clinically important because:
Large, buoyant LDL
Less atherogenic. Associated with low AIP values. Less likely to penetrate arterial walls.
Small, dense LDL
More atherogenic. Associated with high AIP values. More easily oxidized and more likely to form plaques.
Standard lipid panels don't measure LDL particle size directly. AIP provides a practical surrogate marker using routine blood tests.
AIP Values in Different Populations
| Group | Typical AIP | Risk Level |
|---|---|---|
| Healthy young women | < 0.1 | Very low |
| Healthy children | < 0.1 | Very low |
| Men (general) | 0.1 – 0.2 | Low-moderate |
| Hypertensive patients | 0.2 – 0.4 | Elevated |
| Diabetic patients | 0.2 – 0.5 | High |
| CAD patients | > 0.4 | Very high |
AIP vs TG/HDL Ratio
Both markers use triglycerides and HDL. How do they differ?
| Aspect | AIP | TG/HDL Ratio |
|---|---|---|
| Formula | log₁₀(TG / HDL-C) | TG ÷ HDL-C |
| Scale | Typically -0.3 to +0.7 | Typically 1 to 8+ |
| Distribution | More normalized | Right-skewed |
| Best for | Research, precise tracking | Quick clinical assessment |
Both are valid markers. AIP may be slightly better for research purposes; TG/HDL ratio is easier to calculate mentally.
How to Improve Your AIP
High AIP indicates an atherogenic lipid profile. The good news: this is highly responsive to lifestyle changes.
Dietary Strategies
Reduce refined carbohydrates
Sugars and processed grains elevate TG
Increase omega-3 fatty acids
Fatty fish lowers TG effectively
Consider low-carb approach
Often dramatically improves TG/HDL
Limit alcohol
Significantly raises TG in many people
Lifestyle Factors
Add aerobic exercise
Raises HDL and lowers TG
Lose excess weight
Improves lipid profiles significantly
Improve sleep quality
Poor sleep worsens lipid profiles
Manage stress
Chronic stress affects metabolism
Typical Improvement Timeline
Triglycerides respond quickly to dietary changes — often within 2-4 weeks. HDL takes longer to rise, typically 2-3 months of consistent exercise. Most people see meaningful AIP improvement within 2-3 months of lifestyle intervention.
Key Takeaways
- 1AIP is a logarithmic ratio of triglycerides to HDL cholesterol
- 2Lower AIP is better: < 0.11 indicates low cardiovascular risk
- 3AIP strongly correlates with LDL particle size — a key CVD risk factor
- 4Can be calculated from any standard lipid panel
- 5Highly responsive to dietary changes, especially carbohydrate reduction
- 6Similar to TG/HDL ratio but with normalized distribution
References
- Dobiásová M, Frohlich J (2001). The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem, 34(7), 583-588. PMID: 11738396
- Dobiásová M (2004). Atherogenic index of plasma [log(triglycerides/HDL-cholesterol)]: theoretical and practical implications. Clin Chem, 50(7), 1113-1115. PMID: 15229146
- Dobiásová M (2006). AIP--atherogenic index of plasma as a significant predictor of cardiovascular risk: from research to practice. Vnitr Lek, 52(1), 64-71. PMID: 16526201
- Niroumand S, et al (2015). Atherogenic Index of Plasma (AIP): A marker of cardiovascular disease. Med J Islam Repub Iran, 29, 240. PMID: 26793631
- Edwards MK, Blaha MJ, Loprinzi PD (2017). Atherogenic Index of Plasma and Triglyceride/High-Density Lipoprotein Cholesterol Ratio Predict Mortality Risk Better Than Individual Cholesterol Risk Factors. Mayo Clin Proc, 92(3), 460-464. PMID: 28259228
Medical Disclaimer
This article is for educational purposes only. AIP is a screening tool, not a diagnostic test. Always interpret results with your healthcare provider.