Association Between Serum Albumin Levels and Diabetic Peripheral Neuropathy Among Patients with Type 2 Diabetes: Effect Modification of Body Mass Index

Abstract

Ying Hu,1– 3 Jiancheng Wang,1– 3 Sha Zeng,1– 3 Mengxia Chen,1– 3 Guilin Zou,1– 3 Yuxia Li,1– 3 Lingyan Zhu,1– 3 Jixiong Xu1– 3 1Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China; 2Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, Jiangxi, 330006, People’s Republic of China; 3Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, JIangxi, 330006, People’s Republic of ChinaCorrespondence: Jixiong Xu; Jiancheng Wang, Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, No. 17, Yongwaizheng Street, Nanchang, Jiangxi, 330006, People’s Republic of China, Tel/Fax +86-791-86836960, Email Jixiong.Xu@ncu.edu.cn; jasonwong2015@163.comBackground: The role of serum albumin in the risk of diabetic peripheral neuropathy (DPN) remains unclear. This study aimed to explore the relationship between serum albumin level and DPN, and to examine any possible effect modifiers among patients with type 2 diabetes mellitus.Methods: This cross-sectional study was conducted in Jiangxi, China, from May 2012 to December 2014. Serum albumin levels were determined in 523 subjects, and the association between serum albumin level and DPN was evaluated using linear regression models (odds ratio [OR] and corresponding 95% confidence interval [CI]).Results: There was a significant inverse association between serum albumin level (per 1 g/L increment, OR 0.95 [95% CI 0.92– 0.98]) and the risk of DPN. Accordingly, when serum albumin was assessed as quartiles, a significantly lower risk of DPN was found in participants in quartile 4 (OR 0.49 [95% CI 0.25– 0.95]), compared with those in quartile 1. Consistently, higher albumin levels (≥ 35 g/L) were associated with decreased odds for DPN (OR 0.36 [95% CI 0.17– 0.74]) compared with lower levels. Furthermore, the albumin–DPN association was significantly stronger in patients with a relatively high body mass index (BMI; ≥ 24 kg/m2; OR 0.91 [95% CI 0.85– 0.98]) than in those with a low BMI (< 24 kg/m2; OR 0.99 [95% CI 0.94– 1.04]; P for interaction = 0.042).Conclusion: These data suggest that serum albumin level could be a novel risk factor for DPN among patients with type 2 diabetes and relatively high BMI (> 24 kg/m2).Keywords: serum albumin, BMI, diabetic peripheral neuropathy, type 2 diabetes mellitus