Integrated coagulation, platelet, and UACR profiling in type 2 diabetes microvascular complications: a western India study

Aim To evaluate coagulation parameters, platelet indices, and urinary albumin-to-creatinine ratio (UACR) among 310 participants to assess their type 2 diabetes mellitus (T2DM) microvascular complications.Materials and methods This cross-sectional study compared healthy controls (n = 103), uncomplicated T2DM (n = 107), and T2DM with microvascular complications (n = 100). Coagulation times (PT, APTT), fibrinogen, mean platelet volume (MPV), and UACR were analyzed using hierarchical logistic regression and ROC curves.Results A prothrombotic state strongly correlated with disease severity. Median PT (12.5 s to 11.7 s) and APTT (31.0 s to 27.6 s) progressively shortened from controls to the complications group (p < 0.001). Conversely, fibrinogen (2.8 to 3.3 g/L), MPV (8.9 to 9.7 fL), and UACR (1.52 to 4.68 mg/mmol) significantly increased across the same groups. While univariate analysis linked all markers to complications, multivariate modeling confirmed UACR as the marker showing the strongest independent association with microvascular complications (OR = 1.10, 95% CI: 1.06–1.15, p < 0.001). The integrated multivariable model demonstrated good discriminative performance (AUC = 0.857).Conclusion Although shortened coagulation times and elevated platelet indices are significant indicators of vascular risk, UACR showed the strongest independent association with microvascular complications and may serve as a core marker for risk stratification, while coagulation and platelet indices provide complementary information for identifying high-risk individuals.