Association Between Serum Albumin Level and Microvascular Complications of Type 2 Diabetes Mellitus

Jie Zhang; Yuanyuan Deng; Yang Wan; Shasha He; Wei Cai; Jixiong Xu

doi:10.2147/DMSO.S373160

Association Between Serum Albumin Level and Microvascular Complications of Type 2 Diabetes Mellitus

Diabetes Metab Syndr Obes. 2022 Jul 23:15:2173-2182. doi: 10.2147/DMSO.S373160. eCollection 2022.

Authors

Jie Zhang¹, Yuanyuan Deng¹, Yang Wan¹, Shasha He¹, Wei Cai², Jixiong Xu^{1

3

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Affiliations

¹ Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China.
² Department of Medical Genetics and Cell Biology, Medical College of Nanchang University, Nanchang, 330006, People's Republic of China.
³ Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, Jiangxi, 330006, People's Republic of China.
⁴ Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, Jiangxi, 330006, People's Republic of China.

Abstract

Objective: To analyze the associations between serum albumin (sALB) level and diabetic microvascular complications, including diabetic retinopathy (DR) and diabetic kidney disease (DKD), in patients with type 2 diabetes mellitus (T2DM).

Methods: This retrospective study included 951 hospitalized patients with T2DM who had completed screening for DR and DKD during hospitalization. Patients were divided into three groups according to sALB tertiles. Multivariate logistic regression analysis was used to assess the association of sALB with microvascular complications.

Results: The prevalence of DR, DKD and macroalbuminuria increased with decreasing sALB levels. Multivariate logistic regression analysis showed that lower levels of sALB (Q1) were associated with higher risk of DR (odds ratio [OR]: 1.59, 95% confidence interval [CI]: 1.12-2.26), DKD (OR: 3.00, 95% CI: 2.04-4.41) and macroalbuminuria (OR: 9.76, 95% CI: 4.62-20.63) compared with higher levels of sALB (Q3) after adjustment for other risk factors. After stratification by sex and age, the effect of lower levels of sALB (Q1) on DR incidence was more obvious in patients with male (OR: 1.60, 95% CI: 1.00-2.56), and aged<65 years (OR: 1.74, 95% CI: 1.14-2.65) (P < 0.05 for all); the effect of lower levels of sALB (Q1) on the incidence of DKD was significant in both males (OR: 3.78, 95% CI: 2.26-6.32) and females (OR: 2.35, 95% CI: 1.26-4.35) (P < 0.05 for all), while only the age <65 years (OR: 3.46, 95% CI: 2.16-5.53) was significant in the age subgroup (P < 0.001).

Conclusion: Decreased sALB levels may be an independent risk indicator of DR and DKD in patients with T2DM, and significantly associated with DKD progression. For DR screening, special attention should be paid to men aged <65 years, while screening for DKD should pay attention to people <65 years old.

Keywords: diabetic kidney disease; diabetic retinopathy; serum albumin; type 2 diabetes mellitus.

Grants and funding

This study was supported by grants from the National Natural Science Funds of China (grant no. 82160140) and Key research and development projects of the Social Development Department of Jiangxi Provincial Department of Science and Technology (grant no. 20201BBG71006).