Zhang Jie, Deng Yuanyuan, Wan Yang, He Shasha, Cai Wei, Xu Jixiong
Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People's Republic of China.
Department of Medical Genetics and Cell Biology, Medical College of Nanchang University, Nanchang, 330006, People's Republic of China.
Diabetes Metab Syndr Obes. 2022 Jul 23;15:2173-2182. doi: 10.2147/DMSO.S373160. eCollection 2022.
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).
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.
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) ( < 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) ( < 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 ( < 0.001).
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.
分析2型糖尿病（T2DM）患者血清白蛋白（sALB）水平与糖尿病微血管并发症（包括糖尿病视网膜病变（DR）和糖尿病肾病（DKD））之间的关联。
这项回顾性研究纳入了951例住院的T2DM患者，这些患者在住院期间完成了DR和DKD筛查。根据sALB三分位数将患者分为三组。采用多因素逻辑回归分析评估sALB与微血管并发症的关联。
DR、DKD和大量蛋白尿的患病率随sALB水平降低而增加。多因素逻辑回归分析显示，在调整其他危险因素后，与较高sALB水平（Q3）相比，较低sALB水平（Q1）与DR（比值比[OR]：1.59，95%置信区间[CI]：1.12 - 2.26）、DKD（OR：3.00，95% CI：2.04 - 4.41）和大量蛋白尿（OR：9.76，95% CI：4.62 - 20.63）的风险较高相关。按性别和年龄分层后，较低sALB水平（Q1）对男性（OR：1.60，95% CI：1.00 - 2.56）和年龄<65岁（OR：1.74，95% CI：1.14 - 2.65）患者DR发生率的影响更明显（均P<0.05）；较低sALB水平（Q1）对DKD发生率的影响在男性（OR：3.78，95% CI：2.26 - 6.32）和女性（OR：2.35，95% CI：1.26 - 4.35）中均显著（均P<0.05），而在年龄亚组中仅年龄<65岁（OR：3.46，95% CI：2.16 - 5.53）显著（P<0.001）。
sALB水平降低可能是T2DM患者DR和DKD的独立风险指标，并与DKD进展显著相关。对于DR筛查，应特别关注年龄<65岁的男性，而筛查DKD时应关注<65岁的人群。
