Study of Fibrinogen Albumin Ratio in Type 2 Diabetic Patients and Its Correlation With Diabetic Peripheral Neuropathy

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that imposes significant complications, including diabetic peripheral neuropathy (DPN). DPN is characterized by marked inflammation, and the fibrinogen-to-albumin ratio (FAR) is one of the new markers for systemic inflammation, it has been used in various diabetic micro- and macro-vascular complications. The present study investigates the association between FAR and nerve conduction abnormalities in T2DM patients with DPN.

This was a cross-sectional study conducted on 200 T2DM patients, and 110 (55%) were diagnosed with DPN. Patients were divided into DPN and non-DPN groups. The patient's demographics and the biochemical variables fibrinogen, albumin, and FAR were evaluated and compared among the DPN and non-DPN groups. Nerve conduction studies (NCS) were performed to evaluate motor and sensory nerve functions. Patients were further stratified into FAR tertiles (low, moderate, and high FAR) for subgroup analysis.

The fibrinogen levels were significantly higher (375.65 ± 35.43 mg/dL vs. 342.87 ± 42.12 mg/dL; p<0.001) and albumin levels were lower (3.12 ± 0.41 g/dL vs. 4.07 ± 0.57 g/dL; p<0.001) in DPN as compared to non-DPN patients. Meanwhile, FAR was higher in DPN as compared to non-DPN patients (120.40 ± 26.32 vs. 84.24 ± 12.87; p<0.001). Further, there was a significant negative correlation for conduction velocities and amplitudes and a positive correlation for latencies with FAR across all nerves tested (p<0.05). In addition, high FAR tertile patients showed lower conduction velocities (peroneal nerve: 35.26 ± 5.82 m/s vs. 42.53 ± 5.34 m/s; p<0.001), reduced amplitudes, and prolonged latencies when compared to moderate and low FAR tertile patients (p<0.05).

Nerve conduction abnormalities in T2DM patients with DPN showed significant association with FAR. Thus, FAR serves as a simple and effective biochemical marker for the assessment of DPN severity.