Introduction: This study aimed to determine the prevalence of #dyslipidemia and to assess the predictive performance of lipid ratios, specifically the #Atherogenic Index of Plasma (AIP) and the total #cholesterol (TC) to high-density lipoprotein cholesterol (HDL-C) (TC/HDL) ratio, compared to body mass index (BMI) in identifying dyslipidemia among non-obese male university students.
Material and methods: A cross-sectional study was conducted among 150 male students aged 20-30 years at a Saudi Arabian university. Participants underwent fasting lipid profiling, anthropometric measurements, and assessments of lifestyle behaviors including diet, physical activity, and smoking. Dyslipidemia was defined based on the NCEP-ATP III criteria. Predictive accuracy of AIP, TC/HDL ratio, and BMI was evaluated using receiver operating characteristic (ROC) curve analysis and logistic regression.
Results: Dyslipidemia was detected in 60.7% of participants, despite a mean BMI of 25.3 ±4.0 kg/m², indicating that a substantial proportion of metabolically at-risk individuals were not obese. Unhealthy lifestyle behaviors were associated with an approximately eightfold increase in the odds of dyslipidemia (p < 0.001). Both AIP (AUC = 0.865) and TC/HDL ratio (AUC = 0.873) demonstrated significantly superior predictive performance compared with BMI (AUC = 0.570). More than 63% of students were classified as high-risk based on AIP levels. Cluster analysis revealed a distinct LDL-TG dominant phenotype strongly associated with unhealthy lifestyle factors.
Conclusions: Lipid ratios, particularly AIP and TC/HDL, outperformed BMI in predicting early dyslipidemia among non-obese young adults. Incorporating these indices into routine screening could facilitate earlier detection of cardiovascular risk in university and preventive health settings, emphasizing the importance of targeted lifestyle interventions.
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