Association of Blood Glucose and Lipid Parameters with Increasing Albuminuria Severity in Patients with Type 2 Diabetes Mellitus

Background: Diabetic kidney disease is a common complication of type 2 diabetes mellitus and albuminuria is widely used to indicate the presence and severity of renal involvement. Both persistent hyperglycaemia and abnormal lipid metabolism may promote glomerular damage and greater urinary albumin loss, but the contributions of individual glycaemic and lipid parameters across different albuminuria categories remain uncertain. To evaluate the association of blood glucose and lipid parameters with albuminuria severity among patients with type 2 diabetes mellitus research was performed. Materials and methods: A total of 180 patients were classified into normoalbuminuria, microalbuminuria and macroalbuminuria groups, with 60 participants in each group. Fasting Blood Glucose (FBG), Postprandial Blood Glucose (PPBG), total cholesterol, triglycerides, HDL-C, LDL-C, serum creatinine and urinary Albumin-to-Creatinine Ratio (ACR) were assessed. Group comparisons were performed using the Kruskal–Wallis test. Spearman’s rank correlation was used to examine associations with ACR. Independent predictors of increasing albuminuria severity were evaluated using multivariable ordinal logistic regression and receiver operating characteristic analysis was used to assess discrimination for macroalbuminuria. Results: Median FBG, total cholesterol, triglycerides, serum creatinine and ACR differed significantly across the three albuminuria groups. FBG increased from 7.37 mmol/L in normoalbuminuria to 9.28 mmol/L in macroalbuminuria (p<0.001) while triglycerides increased from 185 to 243 mg/dL (p=0.023). Serum creatinine was also highest in the macroalbuminuria group (1.10 mg/dL, p<0.001). PPBG, HDL-C and LDL-C did not differ significantly across groups. ACR correlated positively with serum creatinine (p=0.315) FBS (p=0.299) triglycerides (p=0.217) total cholesterol (p=0.189) and PPBS (p=0.180). In multivariable analysis, each 1 mmol/L increase in FBG was associated with 16.2% higher odds of greater albuminuria severity (Adjusted OR=1.162, 95% CI 1.075–1.255, p<0.001) while serum creatinine was associated with approximately threefold higher odds (Adjusted OR=3.083, 95% CI 1.655–5.743, p<0.001). Lipid parameters were not independently significant after adjustment. FBG had the highest discriminatory ability for macroalbuminuria, although performance was modest (AUC=0.658, 95% CI 0.573–0.743). Conclusion: Increasing albuminuria severity was primarily associated with poorer fasting glycaemia. Although triglycerides and total cholesterol differed across albuminuria categories, they were not independent predictors after adjustment. IAHS Medical Journal Vol 9(1), June 2026;79-85