Kawaguchi Tomoya, Kobayashi Yuka, Yasukawa Keiko, Miyoshi Kengo, Ishibashi Nagisa, Usami Satoshi, Inaba Yosuke, Sato Masaya, Kurano Makoto, Suzuki Ryo, Aoyama Tomohisa, Yatomi Yutaka, Yamauchi Toshimasa
Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, JPN.
Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, JPN.
Cureus. 2025 May 12;17(5):e83976. doi: 10.7759/cureus.83976. eCollection 2025 May.
Introduction Oxidative stress is known to play a key role in the pathogenesis of diabetic complications. However, a useful biomarker of oxidative stress has not yet been widely adopted in clinical practice. We explored whether the ratio of serum oxidized albumin (human non-mercaptalbumin, HNA) to total albumin (HNA%) is associated with the five-year prognosis of diabetic complications. Methods In this single-center, retrospective cohort pilot study, we evaluated participants with diabetes who had been hospitalized at baseline and regularly followed up as outpatients. We measured the HNA% at baseline and at a five-year follow-up and assessed the development or progression of diabetic complications. We examined the relationship between baseline HNA% and changes in diabetic complications. Results In participants with simple diabetic retinopathy at baseline, lower baseline HNA% was associated with shorter duration of diabetes and with five-year improvement of retinopathy, irrespective of follow-up glycated hemoglobin levels (25.46% vs. 33.71%, p = 0.021). Additionally, in the overall cohort and in the subgroup with baseline chronic kidney disease (CKD) stage G2, baseline HNA% above the cutoff value was associated with increased risk of CKD progression (overall: RR 1.61, p = 0.042, stage G2 only: RR 1.83, p = 0.047). Regarding macrovascular complications, follow-up HNA%, but not baseline HNA%, was related to their development. Conclusions These exploratory findings suggest that HNA% may have potential as an indicator of the five-year prognosis of diabetic retinopathy and diabetic kidney disease. Further prospective studies are warranted to validate these findings.
引言 氧化应激在糖尿病并发症的发病机制中起着关键作用。然而，氧化应激的一种有用生物标志物尚未在临床实践中广泛应用。我们探讨了血清氧化白蛋白（人非巯基白蛋白，HNA）与总白蛋白的比值（HNA%）是否与糖尿病并发症的五年预后相关。
方法 在这项单中心回顾性队列试点研究中，我们评估了基线时住院且作为门诊患者定期随访的糖尿病参与者。我们在基线和五年随访时测量了HNA%，并评估了糖尿病并发症的发生或进展。我们研究了基线HNA%与糖尿病并发症变化之间的关系。
结果 在基线时患有单纯糖尿病视网膜病变的参与者中，较低的基线HNA%与较短的糖尿病病程以及视网膜病变的五年改善相关，与随访糖化血红蛋白水平无关（25.46%对33.71%，p = 0.021）。此外，在整个队列以及基线慢性肾脏病（CKD）G2期亚组中，基线HNA%高于临界值与CKD进展风险增加相关（总体：RR 1.61，p = 0.042，仅G2期：RR 1.83，p = 0.047）。关于大血管并发症，随访时的HNA%而非基线HNA%与其发生有关。
结论 这些探索性发现表明，HNA%可能有潜力作为糖尿病视网膜病变和糖尿病肾病五年预后的指标。需要进一步的前瞻性研究来验证这些发现。
