Association of Atherogenic Lipid Index with Kidney Dysfunction in Patients with Type 2 Diabetes

Abstract

Background: Diabetic kidney disease is a major complication of type 2 diabetes mellitus (T2DM), commonly assessed using estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR). Dyslipidemia may contribute to kidney injury, and the Atherogenic Lipid Index (ALI), derived from triglyceride and high-density lipoprotein cholesterol levels, may provide a simple marker of atherogenic lipid abnormalities. Association of atherogenic lipid index with kidney dysfunction in patients with T2DM.
Methods: This cross-sectional analytical study included 294 adults with T2DM. ALI was calculated as log₁₀(triglyceride/HDL-C), with both concentrations expressed in mmol/L. Participants were categorized according to tertiles of ALI distribution, with the lower two tertiles (ALI ≤0.59) compared with the highest tertile (ALI >0.59).
Results: Reduced kidney function was more prevalent in the highest ALI tertile than in the lower two tertiles (30.5% vs. 14.1%; p=0.001), corresponding to higher odds of reduced kidney function (OR 2.68; 95% CI 1.48–4.85). ALI showed modest discrimination for reduced kidney function (AUC 0.647; 95% CI 0.568–0.727), with 56% sensitivity and 59% specificity at a cut-off of 0.52. Albuminuria prevalence did not differ significantly between groups (43.2% vs. 40.2%; OR 1.13; 95% CI 0.69–1.85; p=0.630), and ALI showed no discriminatory ability for albuminuria (AUC 0.489; 95% CI 0.420–0.558).
Conclusions: Higher ALI was associated with reduced kidney function but not albuminuria in patients with T2DM. However, its modest discriminatory performance suggests that ALI should not be considered a stand-alone marker of kidney involvement