Significant Association of Serum Albumin with Severity of Retinopathy and Neuropathy, in Addition to That of Nephropathy, in Japanese Type 2 Diabetic Patients

Abstract

Abstract. Objective: The aim of this study was to determine the association between serum albumin and the severity of microvascular complications and presence of coronary artery disease in type 2 diabetic patients. Patients and Methods: The presence of diabetic complications was assessed in a total of 130 Japanese patients with type 2 diabetes mellitus. Retinopathy was classified as absent, simple or proliferative diabetic retinopathy. Neuropathy was considered to be present when the patient showed absence of Achilles tendon reflex, and also evaluated by measuring the median motor nerve conduction velocity (MNCV) in the nerve conduction study. Results: In relation to retinopathy, there were 83 patients with no retinopathy (absent), 26 with simple retinopathy and 21 with proliferative retinopathy. There was a significant difference in the serum albumin level between the "absent" group and the other two groups. In relation to nephropathy, there were 68 patients with no evidence of nephropathy, 49 with microalbuminuria and 13 with proteinuria. The results of logistic regression analysis with adjustment for three variables (age, gender, serum CRP) revealed that serum albumin was independently related to proliferative retinopathy and proteinuria. In relation to neuropathy, serum albumin was found to be significantly related to the absence of Achilles tendon reflex, MNCV, and MFWL. The results of multiple regression analysis with adjustment for three variables (age, gender, serum CRP) revealed that serum albumin was independently related to MNCV and MFWL. Conclusions: Serum albumin was significantly associated with the severity of retinopathy and neuropathy.

Prevalence and risk factors for severity of diabetic neuropathy in type 2 diabetes mellitus

“…Therefore, microvascular complications such as diabetic nephropathy and diabetic neuropathy go hand in hand in persons with diabetes. [15] The limitation of the present study is the use of a single measurement (biothesiometry) for diagnosing neuropathy; however, other diagnostic measures such as nerve conduction studies and neuropathy symptom score estimations are somewhat cumbersome in large epidemiological studies. Another limitation is the point estimation of risk factors which cannot prove a causal association.…”

Prevalence and predictors of peripheral neuropathy in nondiabetic children with chronic kidney disease

“…found that there was no significant association of patient age, duration of dialysis, etiology of uremia, or efficiency of dialysis with the occurrence of neuropathy. A significant association of serum albumin with neuropathy severity has been reported in patients with diabetes . Chronic inflammation in patients with CKD might lead to a decrease in albumin synthesis.…”

“…A significant association of serum albumin with neuropathy severity has been reported in patients with diabetes. 35 Chronic inflammation in patients with CKD might lead to a decrease in albumin synthesis. Low serum albumin seen in our patients might have been due to albuminuria or decreased albumin synthesis.…”

Serum albumin is associated with peripheral nerve function in patients with type 2 diabetes

“…Indeed, a cohort study of 343 T2DM patients demonstrated that hypoalbuminemia was independently associated with progression of nephropathy as evaluated by rate of decline of estimated glomerular filtration rate [41]. Additionally, in a Japanese study comprising 130 T2DM patients [42], Iwasaki et al reported that serum albumin was significantly associated with the severity of neuropathy, retinopathy, and nephropathy. With respect to neuropathy, it is notable that serum albumin was independently related to median motor nerve CV after adjusting for three variables (age, sex, serum C-reactive protein).…”