The third study, evaluated the association between PRAL, NEAP and metabolic risk factors among patients with T2DM, the prevalence of metabolic syndrome tend to decrease in PRAL or NEAP groupings while the odds of metabolic syndrome in the highest group of PRAL [OR = 2.22; CI: 1.04–4.83] or NEAP was higher than the lowest group as the reference group [OR = 2.61; CI: 1.25–5.55; P <0.001] after adjustment for age, sex, serum uric acid and creatinine, total energy intake, carbohydrate intake and sodium intake. Here, PRAL is linked to type 2 diabetes mellitus.