Fibrinogen to Albumin Ratio as an Independent Risk Factor for Type 2 Diabetic Kidney Disease

Kai Wang; Wenjun Xu; Bingbing Zha; Jindong Shi; Guowei Wu; Heyuan Ding

doi:10.2147/DMSO.S337986

Fibrinogen to Albumin Ratio as an Independent Risk Factor for Type 2 Diabetic Kidney Disease

Diabetes Metab Syndr Obes. 2021 Nov 15:14:4557-4567. doi: 10.2147/DMSO.S337986. eCollection 2021.

Authors

Kai Wang^#^{1

2}, Wenjun Xu^#³, Bingbing Zha¹, Jindong Shi², Guowei Wu³, Heyuan Ding^{1

3}

Affiliations

¹ Department of Endocrinology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, People's Republic of China.
² Department of Respiratory and Critical Care Medicine, Shanghai Fifth People's Hospital, Fudan University, Shanghai, People's Republic of China.
³ Department of Nephrology, Zhejiang Kaihua County Hospital of Chinese Medicine, Zhejiang, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Diabetic kidney disease (DKD) is an inflammatory disease. This study aimed to investigate the association of fibrinogen to albumin ratio (FAR) with DKD.

Patients and methods: A total of 1022 type 2 diabetes mellitus (T2DM) patients with DKD and 1203 T2DM patients without DKD were enrolled in this study. Laboratory values including blood cell count, hemoglobin A1c, biochemical parameters, and fibrinogen and albumin creatinine ratio were recorded. Patients were classified according to tertile of admission FAR. Clinical parameters were compared between groups. Logistic regression, linear regression, ROC analysis and spline regression were carried out.

Results: FAR in the DKD group was significantly higher than that in the non-DKD group. FAR had the highest odds ratio as an independent risk factor for the development of DKD and the highest area under ROC curve for predicting DKD compared with albumin (ALB) or fibrinogen (FIB) alone. Simple linear regression analyses revealed a significant and linear correlation of FAR with neutrophil and neutrophil-to-lymphocyte ratio. FAR was an independent risk factor for development of DKD. Spline regression showed that there was a significant linear association between DKD incidence and continuous FAR value when it exceeded 67.3mg/g.

Conclusion: FAR is a stronger independent predictor of DKD than FIB and ALB. FAR is an independent risk factor for DKD development when it exceeded 67.3mg/g. FAR might be one of novel diagnostic biomarkers to predict and prevent DKD progression. However, a prospective study to validate the prognostic model is still needed.

Keywords: diabetic kidney disease; fibrinogen to albumin ratio; inflammation; type 2 diabetes mellitus.

Grants and funding

This work was supported in part by Science Foundation of Shanghai Fifth People’s Hospital (No.2018WYZT03), Medical Key Faculty Foundation of Shanghai (No. ZK2019B15), Science Foundation of Kaihua County (No.2019004), and Science and Technology Foundation of Quzhou City (No.2019147).