ALB and peripheral arterial disease: Previous studies have showed that higher RAR is associated with an increased risk of peripheral arterial disease.[37] Additionally, a study has shown that RAR is significantly associated with carotid plaques in CHD patients.[27] Moreover, hyperglycemia and insulin resistance exacerbate inflammation and oxidative stress, while simultaneously reducing albumin synthesis, further increasing RAR and accelerating coronary artery calcification.[38,39] These findings align with our results, which show that RAR is more sensitive to CHD risk in diabetic patients compared to non-diabetic individuals.