Diabetes, Metabolic Syndrome and Obesity (Oct 2023)

Influence of Fibrinogen/Albumin Ratio and Fibrinogen/Pre-Albumin Ratio on Cardiac Autonomic Neuropathy in Type 2 Diabetes

  • Zhao S,
  • Yang Z,
  • Yu M,
  • Xiang L,
  • Lv Y,
  • Tian C,
  • Li R

Journal volume & issue
Vol. Volume 16
pp. 3249 – 3259

Abstract

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Subei Zhao, Zheng Yang, Meng Yu, Linyu Xiang, Yuhuan Lv, Chunyan Tian, Rong Li Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of ChinaCorrespondence: Rong Li, Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, People’s Republic of China, Tel +86 13508385198, Email [email protected]: Subclinical inflammation may be involved in the pathogenesis of diabetic cardiac autonomic neuropathy (DCAN). The purpose of the study is to explore the relationship between novel inflammation biomarkers fibrinogen-albumin ratio (FAR), fibrinogen-prealbumin ratio (FPR), and DCAN in type 2 diabetes mellitus (T2DM).Patients and Methods: A total of 715 T2DM patients were enrolled in this retrospective study, divided into non-DCAN (n=565) and DCAN (n=150) groups by Ewing’s test. Serum fibrinogen, albumin, prealbumin, routine inflammatory and other biochemical markers were measured.Results: Patients with versus without DCAN had higher FAR (10.29 ± 4.83 vs 7.22 ± 2.56 g/g, P < 0.001) and FPR (2.19 ± 1.85 vs 1.43 ± 0.93 g/mg, P < 0.001). As FAR and FPR quartiles increased, the incidence of DCAN increased (Quartile 1 vs Quartile 4: 8.4 vs 42.7%, 9.6 vs 39.2%, respectively, P < 0.001), heart rate variability parameters decreased (P < 0.001); the incidence of diabetic nephropathy, retinopathy and peripheral neuropathy tended to be higher and inflammation factors were more active (P < 0.01). FAR (OR, 95% CI: 1.16, 1.08– 1.25, P < 0.001) and FPR (OR, 95% CI: 1.22, 1.03– 1.44, P = 0.021) were independent determinants of DCAN; the risk of DCAN increased by approximately 65% and 27% with each increase in the standard deviation (SD) of FAR (OR per SD, 95% CI: 1.65, 1.29– 2.11, P < 0.001) and FPR (OR per SD, 95% CI: 1.27, 1.04– 1.56, P = 0.021).Conclusion: FAR and FPR are independent risk factors and may influence DCAN development through inflammation.Keywords: type 2 diabetes mellitus, diabetic cardiac autonomic neuropathy, inflammation, fibrinogen-albumin ratio, fibrinogen-prealbumin ratio

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