Background: This study evaluated the uric acid-to-albumin ratio (UAR) and its association with oxidative stress markers and clinical parameters in patients with type 2 diabetes mellitus (DM) with and without diabetic nephropathy (DN).
Methods: In this comparative cross-sectional study, diabetic patients were divided into two groups: T2DM with nephropathy and T2DM without complications. Clinical, biochemical, oxidative stress, and inflammatory markers were assessed. UAR was calculated and compared between groups. Correlations between UAR and metabolic, oxidative, inflammatory, and lipid parameters were analyzed. Receiver operating characteristic (ROC) analysis was performed to evaluate the diagnostic performance of UAR for DN.
Results: Patients with DN had significantly lower serum albumin levels and higher UAR values compared with uncomplicated diabetic patients (1.15 ± 0.33 vs. 1.09 ± 0.26, p = 0.047). Serum creatinine was significantly higher, whereas HDL and LDL cholesterol levels were lower in the DN group. UAR demonstrated a significant inverse correlation with reduced glutathione (GSH) (r = −0.364, p = 0.013) and HDL cholesterol (r = −0.250, p = 0.034), as well as positive correlations with the neutrophil-to-lymphocyte ratio (NLR) (r = 0.254, p = 0.031). No significant associations were observed between UAR and total antioxidant capacity (TAC) or most lipid and glycemic parameters. ROC analysis demonstrated poor discriminatory ability of UAR for DN (AUC = 0.551, p = 0.426).
Conclusion: UAR is modestly elevated in DN group and is associated with selected oxidative stress and inflammatory markers; however, its limited diagnostic performance restricts its utility as a standalone biomarker.