School of Public Health, Shenzhen University Health Science Center, Shenzhen, Guangdong, P. R. China.
Department of Health Management, Beijing Xiaotangshan Hospital, Beijing, P. R. China.
Diabetes Metab Res Rev. 2020 Jul;36(5):e3296. doi: 10.1002/dmrr.3296. Epub 2020 Feb 20.
The study aimed to investigate the associations of baseline serum albumin level and its dynamic change with type 2 diabetes mellitus (T2DM) risk in a large Chinese cohort study.
This cohort study included 30 442 adults without T2DM at first entry, who completed at least one follow-up of annual examinations between 2009 and 2016. Serum albumin level was measured at baseline and at every annual check-up. The dynamic change in serum albumin level (∆ALB) was calculated by subtracting serum albumin level at baseline from that at the last follow-up. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with Cox regression models.
During 7 years of follow-up, we identified 1634 T2DM events. From the lowest to the highest quartile of serum albumin level, adjusted HRs (95% CI) were 1.00 (reference), 0.96 (0.94, 1.01), 0.98 (0.95, 1.02) and 0.88 (0.85, 0.98), respectively. As compared with stable change in serum albumin (-0.2 ≤ ∆ALB <1.0 g/L), the risk of T2DM increased for ∆ALB < -2.0 g/L (HR 1.44, 95% CI 1.24-1.68) and decreased for ∆ALB ≥3.0 g/L (0.81, 0.68-0.97) after adjusting for potential confounding factors. Restricted cubic splines showed a linear dose-response association between baseline serum albumin level and T2DM risk (P 0.715) and a nonlinear dose-response association between ∆ALB and T2DM risk (P 0.011).
Baseline serum albumin level appears to be inversely associated with T2DM risk. Adults with reduced serum albumin level could be early identified for diabetes risk in clinical practice.
本研究旨在通过一项大型中国队列研究，探讨基线血清白蛋白水平及其动态变化与 2 型糖尿病（T2DM）风险之间的关联。
本队列研究纳入了 30442 名初次入组时无 T2DM 的成年人，他们在 2009 年至 2016 年期间至少完成了一次年度检查随访。在基线和每次年度检查时测量血清白蛋白水平。通过从最后一次随访时的血清白蛋白水平中减去基线时的血清白蛋白水平来计算血清白蛋白水平的动态变化（∆ALB）。使用 Cox 回归模型计算风险比（HR）和 95%置信区间（CI）。
在 7 年的随访期间，我们共发现 1634 例 T2DM 事件。血清白蛋白水平从最低到最高四分位数依次为，校正后的 HR（95%CI）分别为 1.00（参考）、0.96（0.94，1.01）、0.98（0.95，1.02）和 0.88（0.85，0.98）。与血清白蛋白稳定变化（-0.2≤∆ALB<1.0 g/L）相比，∆ALB<-2.0 g/L 时 T2DM 的发病风险增加（HR 1.44，95%CI 1.24-1.68），而∆ALB≥3.0 g/L 时 T2DM 的发病风险降低（0.81，0.68-0.97），校正潜在混杂因素后结果仍然如此。限制三次样条显示，基线血清白蛋白水平与 T2DM 风险之间呈线性剂量反应关系（P<0.715），而 ∆ALB 与 T2DM 风险之间呈非线性剂量反应关系（P<0.011）。
基线血清白蛋白水平与 T2DM 风险呈负相关。在临床实践中，可通过检测血清白蛋白水平来识别有发生糖尿病风险的成年人。
