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

Abstract

The aim of this study is to investigate the association between serum albumin concentrations and nerve conduction (NC) parameters in Chinese patients with type 2 diabetes (T2DM). A total of 409 T2DM patients were enrolled between October 2010 and April 2014. All participants underwent nerve conduction studies. The composite Z scores for NC parameters including conduction velocity (CV), amplitude, and latency were calculated as well. Serum albumin was measured by Bromcresol Green dye-binding method. The composite Z scores of CV and amplitude increased with the increasing albumin tertiles (test for trend, both P < 0.001), while the composite Z score of latency decreased with increasing albumin tertiles (test for trend, P < 0.001). After adjusting for age, sex, duration, and HbA1c, higher serum albumin concentrations were associated with higher composite Z scores of CV (β = 0.314, P < 0.001), amplitude (β = 0.279, P < 0.001), and lower composite Z score of latency (β = -0.279, P < 0.001). When participants were stratified into albuminuria and normoalbuminuria group, we found the associations of serum albumin with composite Z scores of NC parameters remained significant only in the albuminuria group (CV Z score: β = 0.253, P = 0.002; amplitude Z score: β = 0.233, P = 0.006; latency Z score: β = -0.217 P = 0.013) after further adjustment for urinary albumin to creatinine ratio. The optimal cutoff point of serum albumin to indicate abnormal peripheral nerve function was 36.75 g/L in T2DM patients with albuminuria, with a sensitivity of 65.6 % and a specificity of 78.0 %. Serum albumin was independently associated with peripheral nerve function in T2DM patients, especially in those with albuminuria. Serum albumin could be a potential biomarker for diabetic peripheral neuropathy.

Prealbumin to fibrinogen ratio is closely associated with diabetic peripheral neuropathy

“…The inflammation, coagulation and nutrition are associated with DPN occurrence and development (9,10,11,12,15,17). The present study finds the first evidence in suggesting that PFR is closely related with DPN in T2DM.…”

“…Secondly, ALB is an important nutritional biomarker as well as an inflammatory marker (16). Li et al suggested that serum ALB was independent with the peripheral nerve function in T2DM, especially to those T2DM patient albuminuria (17). In addition, recent studies have reported that PALB is served as another important biomarker for nutritional status and it is more sensitive to malnutrition than ALB (18,19).…”

“…Albumin (ALB) is a nutrition marker and an inflammation marker (16). Li et al showed the serum ALB was independently associated with peripheral nerve function in T2DM patients, especially in those with albuminuria (17). In recent studies, the prealbumin (PALB) is served as another important biomarker for nutritional status.…”

Low serum magnesium levels are associated with impaired peripheral nerve function in type 2 diabetic patients

“…Peripheral nerve function was evaluated by NCS with the use of the EMG Myto, EBNeuro (ESAOTE, Florence, Italy), which has been described previously41. Briefly, NCS were performed by experienced electrophysiologists who were unaware of the laboratory results.…”

“…Abnormal NC was defined by abnormality of one or more parameters in two or more tested anatomical nerves42. Composite z scores of CV, amplitude, and latency were constructed as previously described4143.…”