The Ratio of Fibrinogen to Albumin is Related to the Occurrence of Retinopathy in Type 2 Diabetic Patients

Figures & data

Table 1 Baseline Patient Characteristics and Laboratory Results

Variable	NDR Group (n = 297)	DR Group (n = 203)	Statistic	P
Age (years)	54(45,62)	58(50,67)	−4.243	<0.001*
Male	167(56.20%)	101(49.80%)	2.033	0.154
DM duration (years)	5(1,10)	11(6,18)	−7.797	<0.001*
BMI (Kg/m^2)	26.57(24.06,28.52)	25.44(23.61,28.04)	−2.285	0.022*
Smoking (%)	82(27.60%)	54(26.60%)	0.062	0.803
Drinking (%)	81(27.30%)	55(27.10%)	0.002	0.965
SBP (mmHg)	131.31±17.30	136.61±17.95	−3.313	0.001*
DBP (mmHg)	82.57±10.80	81.59±10.88	0.991	0.322
Hypertension	120(40.40%)	91(44.80%)	0.967	0.325
DPN (%)	133(44.80%)	160 (78.8%)	57.581	<0.001*
FBG (mmol/l)	8.24(6.3,10.72)	8.64(6.59,10.92)	−0.844	0.399
HbA1c (%)	8.6(7,10.5)	9.1(8,10.2)	−2.471	0.013*
TC (mmol/l)	4.73(3.88,5.5)	4.57(3.7,5.45)	−1.162	0.245
TG (mmol/l)	1.57(1.05,2.33)	1.44(0.97,2.07)	−1.698	0.090
LDL (mmol/l)	3.11±0.90	3.01±0.96	1.141	0.254
HDL (mmol/l)	1.05 (0.9, 1.24)	1.07 (0.91, 1.22)	−0.387	0.699
SUA (µmol/L)	316.9 (263, 374.65)	291 (244.6, 349.2)	−2.772	0.006*
BUN (mmol/L)	5.2 (4.4, 6.2)	5.3 (4.6, 6.5)	−1.802	0.072
Scr (µmol/L)	63.6 (54.65, 72.85)	63.8 (54.3, 75.6)	−0.114	0.909
GFR (mL/min)	103.58 (94.68,112.22)	97.64(90.28,109.96)	−3.33	0.001*
ALT (U/L)	22.2(15.35,31.85)	17.8(12.9,24.4)	−4.206	<0.001*
AST (U/L)	20.2(16.8,24.95)	19(15.7,25.19)	−1.999	0.046*
ALB (g/L)	43.1(40.4,45.35)	40.9(38.5,43.7)	−5.524	<0.001*
FIB (mg/dL)	251(224,281)	290(240,341)	−6.595	<0.001*
Neutrophils (10^9 /L)	3.49(2.91,4.125)	3.78(3.02,4.76)	−2.663	0.008*
Lymphocytes (10^9 /L)	1.88(1.49,2.31)	1.73(1.41,2.22)	−2.202	0.028*
NLR	1.82(1.45,2.35)	2.12(1.60,2.77)	−3.661	<0.001*
FAR	5.86 (5.21, 6.64)	6.83 (5.89, 8.22)	−7.895	<0.001*

Notes: data are expressed as mean ± standard deviation or median (25th - 75th interquartile spacing). *Indicates statistical significance (P < 0.05).

Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; DPN, diabetic peripheral neuropathy; FBG, fasting blood glucose; HbA1c, glycated hemoglobin; TC, total cholesterol; TG, triglycerides; LDL, low-density lipoprotein; HDL, high density lipoprotein; SUA, serum uric acid; BUN, urea nitrogen; Scr, serum creatinine; GFR, glomerular filtration rate; ALT, alanine aminotransferase; AST, aspartate aminotransferase; ALB, albumin; FIB, fibrinogen; NLR, neutrophil to lymphocyte ratio; FAR, fibrinogen to albumin ratio.

Table 2 Comparison of General Data and Biochemical Indexes Between NPDR and PDR Groups

Variable	NPDR Group (n = 182)	PDR Group (n = 21)	Statistic	P
Age (years)	58(50,67)	59(48.5,66)	−0.29	0.771
Male	91(50.00%)	10(47.60%)	0.043	0.836
DM duration (years)	10(5.75,17)	22(17,30)	−5.494	<0.001*
BMI (Kg/m^2)	25.19(23.44,27.94)	26.85(24.54,30.09)	−1.663	0.096
Smoking (%)	49(26.90%)	5(23.80%)	0.093	0.76
Drinking (%)	52(28.60%)	3(14.30%)	1.945	0.163
SBP (mmHg)	136.71±17.84	135.71±19.25	0.24	0.811
DBP (mmHg)	81.69±10.93	80.71±10.60	0.389	0.697
Hypertension	82(45.10%)	9(42.90%)	0.037	0.848
DPN (%)	141(77.50%)	19(90.50%)	1.907	0.167
FBG (mmol/l)	8.48(6.50,10.93)	9.03(6.8,10.56)	−0.647	0.517
HbA1c (%)	9.1(7.98,10.33)	8.6(8,9.7)	−0.936	0.349
TC (mmol/l)	4.58(3.66,5.46)	4.56(3.92,5.07)	−0.01	0.992
TG (mmol/l)	1.45(0.92,2.09)	1.43(1.03,1.89)	−0.041	0.967
LDL (mmol/l)	3.0251±0.96264	2.9105±0.91265	0.519	0.604
HDL (mmol/l)	1.06(0.91,1.21)	1.12(0.97,1.30)	−1.042	0.298
SUA (µmol/L)	288.8 (242.475,348.45)	299.7 (245.5,368.75)	−0.457	0.648
BUN (mmol/L)	5.3(4.6,6.53)	5(4.65,5.8)	−0.891	0.373
Scr (µmol/L)	64.72±16.46	66.3±12.53	−0.425	0.671
GFR (mL/min)	98.66±16.45	97.20±13.74	0.392	0.696
ALT (U/L)	18.2(12.88,24.7)	15.5(12.8,21.55)	−1.114	0.265
AST (U/L)	19(15.88,25.35)	18.8(13.1,21.65)	−1.112	0.266
ALB (g/L)	41.05(38.65,43.93)	40.3 (37.25,41.15)	−1.738	0.082
FIB (mg/dL)	284 (238.75, 335.75)	339 (275,422)	−2.436	0.015*
Neutrophils (10^9 /L)	3.7(3.03,4.63)	4.15(2.94,6.21)	−1.76	0.078
Lymphocytes (10^9 /L)	1.74(1.45,2.24)	1.51(1.25,1.96)	−1.271	0.204
NLR	2.08(1.59,2.66)	2.77(1.87,3.74)	−2.499	0.012*
FAR	6.70 (5.83, 8.02)	8.25 (6.84, 10.81)	−2.736	0.006*

Notes: data are expressed as mean ± standard deviation or median (25th-75th interquartile spacing). *Indicates statistical significance (P < 0.05).

Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; DPN, diabetic peripheral neuropathy; FBG, fasting blood glucose; HbA1c, glycated hemoglobin; TC, total cholesterol; TG, triglycerides; LDL, low-density lipoprotein; HDL, high density lipoprotein; SUA, serum uric acid; BUN, urea nitrogen; Scr, serum creatinine; GFR, glomerular filtration rate; ALT, alanine aminotransferase; AST, aspartate aminotransferase; ALB, albumin; FIB, fibrinogen; NLR, neutrophil to lymphocyte ratio; FAR, fibrinogen to albumin ratio.

Table 3 Univariate Correlation Analysis of FAR with Each Indicator

Item	r	P-value
Age (years)	0.209	<0.001*
Male	0.151	0.001*
DM duration (years)	0.266	<0.001*
BMI (Kg/m^2)	−0.083	0.063
Smoking (%)	−0.155	<0.001*
Drinking (%)	−0.130	0.004*
SBP (mmHg)	0.094	0.036*
DBP (mmHg)	−0.053	0.238
Hypertension	0.098	0.029*
DR	0.353	<0.001*
DPN	0.209	<0.001*
FBG (mmol/l)	−0.002	0.956
HbA1c (%)	0.104	0.02*
TC (mmol/l)	0.003	0.946
TG (mmol/l)	−0.081	0.072
LDL (mmol/l)	0.017	0.708
HDL (mmol/l)	0.013	0.776
SUA (µmol/L)	−0.122	0.006*
BUN (mmol/L)	0.017	0.708
Scr (µmol/L)	−0.102	0.023*
GFR (mL/min)	−0.158	<0.001*
ALT (U/L)	−0.304	<0.001*
AST (U/L)	−0.155	0.001*
ALB (g/L)	−0.468	<0.001*
FIB (g/L)	0.914	<0.001*
Neutrophils (10^9 /L)	0.186	<0.001*
Lymphocytes (10^9 /L)	−0.059	0.189
NLR	0.209	<0.001*

Notes: *Indicates statistical significance (P < 0.05).

Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; DPN, diabetic peripheral neuropathy; FBG, fasting blood glucose; HbA1c, glycated hemoglobin; TC, total cholesterol; TG, triglycerides; LDL, low-density lipoprotein; HDL, high density lipoprotein; SUA, serum uric acid; BUN, urea nitrogen; Scr, serum creatinine; GFR, glomerular filtration rate; ALT, alanine aminotransferase; AST, aspartate aminotransferase; ALB, albumin; FIB, fibrinogen; NLR, neutrophil to lymphocyte ratio; FAR, fibrinogen to albumin ratio.

Figure 1 Simple linear regression analysis of FAR versus NLR for all T2DM patients.

Abbreviations: NLR, neutrophil-to-lymphocyte ratio; FAR, fibrinogen to albumin ratio.

Table 4 FAR Interquartile Spacing and Detection Rate of DR for Trend Test

	FAR Quartiles				Cardinality	P-value
	A (n=125)	B (n=125)	C (n=125)	D (n=125)
DR (%)	14.8%	16.7%	25.1%	43.30%	69.621	<0.001

Note: P < 0.05 was considered statistically significant.

Table 5 Multifactorial Logistic Regression Analysis of DR in Patients with T2DM

	β	SE	Wald X^2	P	OR	95% CI
DM duration (years)	0.072	0.017	17.184	<0.001*	1.075	1.039–1.112
SBP (mmHg)	0.019	0.007	7.651	0.006	1.019	1.005–1.032
DPN (%)	1.292	0.243	28.364	<0.001*	3.639	2.262–5.855
FAR	0.41	0.082	25.031	<0.001*	1.507	1.283–1.769

Note: *Indicates statistical significance (P < 0.05).

Abbreviations: SBP, systolic blood pressure; DPN, diabetic peripheral neuropathy; FAR, fibrinogen to albumin ratio.

Figure 2 ROC curve analysis of the predictive value of fibrinogen to albumin ratio (FAR), duration of diabetes mellitus (DM) and systolic blood pressure (SBP) for DR.