Triglyceride-glucose index, neutrophil-to-lymphocyte ratio, and high-sensitivity C-reactive protein across albuminuria stages in type 2 diabetes.

Diabetic kidney disease (DKD) is a major microvascular complication of type 2 diabetes mellitus (T2DM) and a leading cause of progressive renal failure worldwide. Although urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate remain the cornerstone measures for DKD assessment, simple and readily available biomarkers may provide complementary clinical information. In this cross-sectional study, 300 patients with T2DM were categorized into three groups according to UACR. The study evaluated and compared the triglyceride-glucose (TyG) index, neutrophil-to-lymphocyte ratio (NLR), and high-sensitivity C-reactive protein (hs-CRP) across albuminuria categories. All three biomarkers differed significantly among the albuminuria categories, with the highest levels observed in patients with macroalbuminuria. Receiver operating characteristic analyses demonstrated good discriminatory performance for albuminuria, with both NLR and hs-CRP exhibiting significantly greater discriminatory ability than the TyG index in several comparisons. In adjusted multinomial logistic regression analysis, NLR was independently associated with both microalbuminuria and macroalbuminuria, whereas the TyG index and hs-CRP were independently associated only with macroalbuminuria. These findings support the complementary role of these readily available biomarkers in the assessment of albuminuria in T2DM and provide a basis for future longitudinal studies to clarify their clinical significance.