What This Means
This study followed more than 16,000 people with type 2 diabetes in community health centres in Shenzhen, China, all of whom already had their LDL ("bad") cholesterol under control. The researchers asked whether a measure called the atherogenic index of plasma (AIP), which reflects the balance of triglycerides and HDL ("good") cholesterol, was linked to later diabetes complications affecting the eyes, kidneys, and nerves. Over about 4.6 years, around 1,000 people developed such complications.
People in the highest third of AIP had about a 34% higher risk of developing any of these complications than those in the lowest third. The link was strongest for kidney disease (about 62% higher risk) and nerve damage (about 39% higher risk). The middle group had a higher risk only for kidney disease. No clear link was found for eye disease, although the estimate pointed in the same direction.
This research suggests that having well-controlled LDL cholesterol does not remove the risk of these complications, and that AIP, which is calculated from routine blood tests, might help flag people with remaining risk. Because this was a retrospective study relying on health records and diagnosis codes, it shows association rather than proof of cause, and further research would be needed to confirm whether acting on AIP improves outcomes.