Triglyceride–glucose index, neutrophil-to-lymphocyte ratio, and high-sensitivity C-reactive protein across alb

Diabetic kidney disease is a major microvascular complication of type 2 diabetes mellitus and a leading cause of progressive renal failure worldwide. Although urinary albumin-to-creatinine ratio 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 type 2 diabetes were categorized into three groups according to urinary albumin-to-creatinine ratio. The study evaluated and compared the triglyceride–glucose index, neutrophil-to-lymphocyte ratio, and high-sensitivity C-reactive protein 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 neutrophil-to-lymphocyte ratio and high-sensitivity C-reactive protein exhibiting significantly greater discriminatory ability than the triglyceride–glucose index in several comparisons. In adjusted multinomial logistic regression analysis, neutrophil-to-lymphocyte ratio was independently associated with both microalbuminuria and macroalbuminuria, whereas the triglyceride–glucose index and high-sensitivity C-reactive protein were independently associated only with macroalbuminuria. These findings support the complementary role of these readily available biomarkers in the assessment of albuminuria in type 2 diabetes and provide a basis for future longitudinal studies to clarify their clinical significance.