Abstract
BackgroundPrevious studies that explored the relationship of serum albumin with diabetic peripheral neuropathy (DPN) have indicated inconsistent results. Thus, the present study aimed to evaluated the association between serum albumin and DPN, defined as vibration perception threshold (VPT) values ≥ 25 V and/or inability to feel the monofilament, in Chinese patients with type 2 diabetes mellitus (T2DM).Methods1465 T2DM patients aged ≥ 16 years, who completed the measurement of serum albumin and DPN screening between 2012 and 2015, were included in the cross-sectional study. Correlation and multivariate logistic regression analysis models were used to evaluate the possible relationship between serum albumin and DPN.ResultsPatients with higher quartiles of serum albumin had significantly lower VPT values and prevalence of DPN compared with those with lower quartiles (P for trend < 0.01), and there was an inverse relationship between serum albumin and VPT values and prevalence of DPN (all P < 0.01). Multivariate logistic regression analysis demonstrated that the risk of DPN was progressively decreased across serum albumin quartiles (P for trend < 0.01), and participants in the highest quartile of serum albumin were at a significantly decreased risk of DPN compared to those in the lowest quartile (odds rate: 0.311, 95% confidence intervals 0.134–0.724, P < 0.01). ROC analysis revealed that the optimal cutoff point of serum albumin for the prevalence of DPN was 39.95 g/L in patients with T2DM, with a sensitivity of 65.88% and a specificity of 66.7%.ConclusionsDecreased levels of serum albumin might be correlated with increased risk of DPN in Chinese patients with T2DM. Future longitudinal studies with large samples are warranted to confirm our findings, and elucidate putative mechanisms for the association.
Highlights
Previous studies that explored the relationship of serum albumin with diabetic peripheral neuropathy (DPN) have indicated inconsistent results
Predictive value of serum albumin for the prevalence of DPN in patients with type 2 diabetes mellitus (T2DM) Receiver operating characteristic (ROC) analysis revealed that the optimal cutoff point of serum albumin was 39.95 g/L for the prevalence of DPN (AUC = 0.720; 95% confidence intervals (CI), 0.685–0.755; Youden index = 0.326; sensitivity, 65.88%; specificity, 66.7%) in diabetic patients (Fig. 1)
In the present study, we found that patients in the highest quartile of serum albumin had lower prevalence of DPN compared with those in the lowest quartile (P < 0.01), and serum albumin showed a negative association with vibration perception threshold (VPT) values and prevalence of DPN
Summary
Previous studies that explored the relationship of serum albumin with diabetic peripheral neuropathy (DPN) have indicated inconsistent results. There is extensive evidence that serum albumin has many physiological properties, including antioxidant, anti-inflammatory, antiplatelet agglutination, and anticoagulant activities, regulating immune response, preventing apoptosis of endothelial cell, Schwann cells and neuronal, dilating blood vessel, protecting neurons against ischemia and reperfusioninduced injury, and improving neuronal functional recovery [6,7,8,9,10,11,12,13]. Together, these findings suggest that albumin may confer robust neuroprotection, and lower levels of serum albumin may be involved in the development of DPN. Such differences regarding the association between serum albumin and DPN in these literatures may be due to differences in study design and population, diabetic duration, diagnostic methods for DPN, confounding factors adjusted, and sample size
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