Blood Urea Nitrogen to Albumin Ratio is Associated with Diabetic Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus

Purpose: Blood urea nitrogen (BUN) to albumin ratio (BAR) serves as a multifaceted parameter indicative of inflammatory, renal, endothelial, and nutritional functions. Previous studies have demonstrated that an elevated BAR is a valuable biomarker with predictive significance in various diseases. Nonetheless, the association between BAR and diabetic peripheral neuropathy (DPN) has not been previously documented. This study seeks to explore the potential association between BAR and DPN in patients with type 2 diabetes mellitus (T2DM). Patients and Methods: A total of 3239 patients diagnosed with T2DM admitted to the Second Affiliated Hospital of Wenzhou Medical University from 2018 to 2023 were included in this cross-sectional study. The analysis was conducted through logistic regression and restricted cubic spline (RCS) methodologies, complemented by additional stratified and interaction analyses. Results: As the quartiles of BAR increased, there was a notable increase in the prevalence of DPN, with the rates of 13.3%, 19.4%, 26.0%, and 38.3%, respectively. Logistic regression analysis showed a positive association between BAR and DPN (OR=1.20, 95% CI: 1.12– 1.28), which was consistently observed across all subgroups through stratified analysis. RCS analysis identified a linear association, without saturation effects. Additionally, AUC for BAR (AUC = 0.660, 95% CI: 0.639– 0.683) was significantly higher compared to those of BUN and albumin alone. Conclusion: BAR exhibits a positive association with the risk of DPN, underscoring its potential utility as a cost-effective biomarker for stratifying the risk of DPN. Keywords: BUN, albumin, DPN, T2DM, inflammation