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

BACKGROUND: 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/m(2); OR 0.91 [95% CI 0.85–0.98]) than in those with a low BMI (<24 kg/m(2); 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/m(2)).