Serum albumin concentration and incident type 2 diabetes risk: new findings from a population-based cohort study

Serum albumin concentrations may be associated with future risk of type 2 diabetes, but the epidemiological evidence is limited and uncertain. We prospectively assessed the association between baseline values of serum albumin and incident type 2 diabetes risk in the Kuopio Ischaemic Heart Disease population-based cohort study.

We analysed the data of 1,785 men aged 42–61 years with no known history of diabetes at baseline. Participants’ serum albumin concentrations were measured at baseline. HRs and 95% CIs for type 2 diabetes events were subsequently assessed.

During a mean follow-up of 20.4 years, 382 participants developed diabetes. Serum albumin concentrations were weakly correlated with several established risk factors for diabetes. Serum albumin was approximately linearly associated with type 2 diabetes risk. In analyses adjusted for several conventional risk factors, the HR for type 2 diabetes per 1 SD increase in serum albumin was 1.15 (95% CI 1.03, 1.28; p = 0.016), which persisted after further adjustment for triacylglycerol, C-reactive protein, γ-glutamyltransferase, estimated glomerular filtration rate and total energy intake (HR 1.15; 95% CI 1.02, 1.29; p = 0.018). The findings were generally consistent across several clinical subgroups. Addition of information on serum albumin to a diabetes risk prediction model containing conventional risk factors led to no significant change in C-index (0.0126; 95% CI −0.0055, 0.0306; p = 0.17).

A near linear, positive and independent association was found between serum albumin and type 2 diabetes, but this did not improve event discrimination. Further work is warranted to evaluate the causal relevance of these findings.