Comparative analysis of triglyceride-glucose index, neutrophil-lymphocyte ratio and hs-CRP across albuminuria stages in type 2 diabetes

Diabetic kidney disease (DKD) is a major microvascular complication of type 2 diabetes mellitus (T2DM) and a leading cause of progressive renal failure worldwide. Conventional diagnostic methods have limitations, highlighting the need for simple, cost-effective, and widely accessible tools for early risk assessment. In this cross-sectional study, 300 patients with T2DM were categorized into three groups according to urinary albumin-to-creatinine ratio. We evaluated and compared the triglyceride-glucose (TyG) index, neutrophil-lymphocyte ratio (NLR), and high-sensitivity C-reactive protein (hs-CRP) as markers of DKD across albuminuria stages. TyG index, NLR, and hs-CRP increased progressively from normoalbuminuria to macroalbuminuria. Receiver operating characteristic analysis demonstrated good diagnostic performance of all markers, with NLR showing high sensitivity and specificity. Multivariate logistic regression identified NLR as significantly associated with disease severity, whereas TyG index and hs-CRP were primarily linked to advanced DKD stages. These findings suggest that TyG index, NLR, and hs-CRP are simple, measurable markers associated with DKD in T2DM patients. NLR correlates with both early and advanced albuminuria stages, suggesting an association with disease severity, while TyG index and hs-CRP are more relevant for advanced stages. The combined evaluation of these markers could be explored in future studies for potential risk stratification across DKD stages.