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ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1456731
This article is part of the Research Topic Re-visiting Risk Factors for Cardiometabolic Diseases: Towards a New Epidemiological Frontier View all 23 articles
The Relationship Between Blood Urea Nitrogen to Serum Albumin Ratio and Cardiovascular Diseases, Cardiovascular Mortality, and All-Cause Mortality in Patients with Diabetes Mellitus
Provisionally accepted- 1 Krirk University, Bangkok, Thailand
- 2 Baotou Medical College, Baotou, China
- 3 Center for Translational Medicine, the Third People's Hospital of Longgang District, Shenzhen, China
The relationship between the Blood Urea Nitrogen to Albumin Ratio (BAR) and cardiovascular diseases in diabetes, as well as cardiovascular and all-cause mortality, is not yet entirely understood.Objective: This study aimed to examine the correlation between the serum urea nitrogen to albumin ratio and cardiovascular diseases, cardiovascular mortality, and all-cause mortality in diabetes.Methods: The relationship between BAR and cardiovascular diseases, cardiovascular mortality and all-cause mortality in patients with diabetes mellitus was verified using baseline characteristic analysis, multivariate logistic regression analysis, multivariate Cox proportional hazards model, Kaplan-Meier (K-M) analysis, smoothed fitted curves, and subgroup analysis. Results: Results of the logistic regression analysis indicated a substantial positive association, between the BAR and the risk of cardiovascular disease in individuals with diabetes (HR ,1.07[95% CI 1.04-1.10], p <0.001). Cox regression analysis revealed a substantial positive association between the BAR and the risk of cardiovascular(OR,1.07[95%CI,1.04-1.10],p<0.001)and all-cause mortality(OR,1.07[95% CI 1.04-1.10], p <0.001)in diabetes. The restricted cubic spline (RCS) curves indicated a non-linear relationship between BAR and the risk of cardiovascular disease, cardiovascular mortality, and allcause mortality in diabetes (p <0.01). The receiver operating characteristic (ROC) curves demonstrated that the BAR had superior predictive performance for cardiovascular risk (AUC: 0.648), cardiovascular mortality (AUC: 0.618), and all-cause mortality (AUC: 0.674) compared to the body mass index (BMI) and the WWI. These results underscore the enhanced ability of the BAR to discriminate between positive and negative outcomes, making it a more effective predictor than WWI. Kaplan-Meier analysis further verified the predictive capacity of BAR, for cardiovascular mortality and all-cause mortality in diabetes patients. Subgroup analysis revealed consistent associations between BAR and a variety of subgroups. Conclusion: The incidence of cardiovascular disease, cardiovascular mortality, and all-cause mortality was substantially elevated, in patients with diabetes with a higher BAR level. Cardiovascular disease, cardiovascular mortality, and all-cause mortality may be more prevalent among diabetic patients with elevated BAR levels. BAR is a novel marker for the prediction of cardiovascular disease, cardiovascular mortality, and all-cause mortality in diabetes.
Keywords: Blood Urea Nitrogen to Serum Albumin Ratio1, Diabetes mellitus2, Cardiovascular disease3, Cardiovascular Mortality4, all-cause mortality5
Received: 17 Jul 2024; Accepted: 20 Mar 2025.
Copyright: © 2025 ZHU, Xie, Wang, Jiang, Hua and Shao. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hongwei ZHU, Krirk University, Bangkok, Thailand
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