FAR is independently associated with PAD and demonstrates superior discriminatory performance over conventional inflammatory markers, suggesting it may serve as a cost-effective screening tool for identifying high-risk individuals.
Fibrinogen-to-albumin ratio (FAR) was significantly positively correlated with PAD prevalence after adjusting for covariates.
A linear dose-response relationship was observed between FAR and PAD risk across quartiles and confirmed by restricted cubic spline analysis.
FAR achieved superior diagnostic performance compared to other established inflammatory indices in discriminating PAD.
The association between FAR and PAD remained robust across subgroup analyses, with notable consistency in specific subpopulations.
The study population consisted of 4234 participants drawn from a national survey, with PAD defined by ankle-brachial index measurement.
This research suggests that a blood test ratio called the fibrinogen-to-albumin ratio (FAR) — calculated by dividing the level of fibrinogen (a clotting protein linked to inflammation) by the level of albumin (a protein that tends to decrease with inflammation and illness) — is meaningfully linked to peripheral arterial disease (PAD), a condition in which narrowed arteries reduce blood flow to the limbs. Using data from over 4,000 adults in a large U.S. national health survey, the researchers found that higher FAR values were consistently associated with greater odds of having PAD, and this relationship appeared to be linear, meaning the risk increased steadily with rising FAR levels rather than jumping at a specific threshold. This research also suggests that FAR outperforms several other commonly used blood-based inflammatory markers — including the neutrophil-to-lymphocyte ratio, C-reactive protein-to-albumin ratio, platelet-to-lymphocyte ratio, and systemic immune-inflammation index — in distinguishing people with PAD from those without it. At its optimal cutoff value of 8.818%, FAR correctly identified about 68% of PAD cases (sensitivity) and correctly classified about 64% of non-PAD individuals (specificity), yielding an overall discriminatory ability (AUC) of 0.695. The association held up across multiple subgroups, including former smokers and people without kidney problems. Because PAD often has no symptoms in its early stages and can go undetected until serious complications arise, identifying low-cost and widely available screening tools is important. This research suggests that FAR, which can be calculated from routine blood tests already performed in clinical care, could potentially help flag individuals at higher risk of PAD for further vascular assessment, particularly in primary care settings where access to specialized testing may be limited. However, as a cross-sectional study, this research cannot establish that elevated FAR causes PAD, and further longitudinal research would be needed to confirm its value in clinical screening.
Zhu W, Zhang S, Xiang Y, Lv A, Li X, Pu D. (2026). The relationship between fibrinogen-to-albumin ratio and peripheral arterial disease: A cross-sectional study.. Medicine. https://doi.org/10.1097/MD.0000000000050650