Patients with higher AAR quartiles tended to be female and relatively older, less user of smoking, and have longer diabetic duration, higher levels of SBP, HDL-C, apoA, AST, AAR, RDW, serum Cr, urinary ACR, VPT, presence of DPN, DN, hypertension, DFU, PAD, and lower BMI, DBP, TG, LDL-C, apoB, TyG, FBG, HbA1c, ALT, TBIL, GGT, serum ALB, lymphocyte counts, eGFR, ABI, HSL, prevalence of dyslipidemia, NAFLD, and MetS compared to those with lower quartiles (P<0.01 or P<0.05). Here, ALB is linked to metabolic dysfunction-associated steatotic liver disease.