Association between Triglyceride-to-High-Density Lipoprotein Ratio and Urinary Albumin-to-Creatinine Ratio in Patients with Type 2 Diabetes Mellitus in Indonesia

Background: Dyslipidaemia and albuminuria are recognised indicators of diabetic nephropathy. The triglyceride-to-high-density lipoprotein (TG–HDL) ratio has been proposed as a potential predictor of renal complications in type 2 diabetes mellitus (T2DM). Objectives: This study aimed to evaluate the association between TG-HDL ratio and urinary albumin-to-creatinine ratio (UACR) in patients with T2DM. Methods: This retrospective cross-sectional study analysed medical records of hospitalised T2DM patients at Adam Malik Hospital between October 2024 and March 2025. Forty-six patients aged 18 years or older with complete clinical and laboratory data were included. Clinical variables, including TG–HDL ratio, lipid profiles, and UACR, were extracted. Associations were assessed using Fisher’s Exact test and odds ratios (OR) with 95% confidence intervals (CI). Results: The median TG–HDL ratio was 2.0 (IQR 1.0), and the median UACR was 158.5 mg/g. A TG–HDL ratio ≥2.76 was observed in 60.9% of patients. Macroalbuminuria (UACR ≥300 mg/g) occurred in 28.3% of patients, while 54.3% had moderate albuminuria (A2) and 65.2% had dyslipidaemia. A significant association was identified between TG–HDL ratio and UACR (p = 0.049). Patients with TG–HDL ratio ≥2.76 were more likely to develop macroalbuminuria compared with those with lower ratios (OR 5.18; 95% CI 0.99–27.06). Conclusion: An elevated TG–HDL ratio was significantly associated with increased UACR in patients with type 2 diabetes mellitus (T2DM). Individuals with a TG–HDL ratio ≥ 2.76 had a 5.18-fold higher risk of developing macroalbuminuria, underscoring its potential as a simple predictive marker for the early detection of diabetic nephropathy.