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: serum albumin, diabetic kidney disease, diabetic retinopathy, type 2 diabetes mellitus