Association between Serum Albumin Concentration and Ketosis Risk in Hospitalized Individuals with Type 2 Diabetes Mellitus

Objective. This study examined the association between serum albumin concentration and ketosis risk in hospitalized individuals with type 2 diabetes mellitus (T2DM). Methods. A retrospective cross-sectional study was conducted at a medical center in Taiwan. Inclusion criteria were endocrinology ward...

Full description

Saved in:
Bibliographic Details
Main Authors: Po-Chung Cheng, Shang-Ren Hsu, Yun-Chung Cheng
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2016/1269706
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832553575653310464
author Po-Chung Cheng
Shang-Ren Hsu
Yun-Chung Cheng
author_facet Po-Chung Cheng
Shang-Ren Hsu
Yun-Chung Cheng
author_sort Po-Chung Cheng
collection DOAJ
description Objective. This study examined the association between serum albumin concentration and ketosis risk in hospitalized individuals with type 2 diabetes mellitus (T2DM). Methods. A retrospective cross-sectional study was conducted at a medical center in Taiwan. Inclusion criteria were endocrinology ward inpatients exceeding 21 years of age, with preexisting diagnosis of T2DM, and blood glucose above 13.9 millimoles per liter (mmol/L) at admission. Individuals without measurement of serum albumin, urine ketone, or hemoglobin A1C, or harboring active infection, myocardial infarction, cerebrovascular event, cirrhosis, malignancy, or overt proteinuria were excluded. Using serum albumin concentration below 3.0 grams per deciliter to define hypoalbuminemia, 151 hypoalbuminemic cases and 104 normoalbuminemic controls were enrolled. The presence of ketones in urine established ketosis. Results. The prevalence of ketonuria was 48% in hypoalbuminemic subjects compared to 30% in normoalbuminemic controls (odds ratio (OR): 2.15; 95% confidence interval (CI): 1.26–3.57; P=0.004). Moreover, among the 156 subjects with serum beta-hydroxybutyrate measurement in addition to urine ketone, 33% of the hypoalbuminemic individuals had ketonemia exceeding 3 mmol/L compared to 19% of those with normoalbuminemia (OR: 2.12, 95% CI: 0.99–4.48, P=0.051). Conclusions. Serum albumin concentration is inversely associated with ketosis risk in hospitalized individuals with T2DM.
format Article
id doaj-art-d383bdb476b64f12bdf3ac9fd4ec0be5
institution Kabale University
issn 2314-6745
2314-6753
language English
publishDate 2016-01-01
publisher Wiley
record_format Article
series Journal of Diabetes Research
spelling doaj-art-d383bdb476b64f12bdf3ac9fd4ec0be52025-02-03T05:53:49ZengWileyJournal of Diabetes Research2314-67452314-67532016-01-01201610.1155/2016/12697061269706Association between Serum Albumin Concentration and Ketosis Risk in Hospitalized Individuals with Type 2 Diabetes MellitusPo-Chung Cheng0Shang-Ren Hsu1Yun-Chung Cheng2Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanxiao Street, Changhua City, Changhua County 500, TaiwanDivision of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, 135 Nanxiao Street, Changhua City, Changhua County 500, TaiwanDepartment of Radiology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sector 4, Taichung 40705, TaiwanObjective. This study examined the association between serum albumin concentration and ketosis risk in hospitalized individuals with type 2 diabetes mellitus (T2DM). Methods. A retrospective cross-sectional study was conducted at a medical center in Taiwan. Inclusion criteria were endocrinology ward inpatients exceeding 21 years of age, with preexisting diagnosis of T2DM, and blood glucose above 13.9 millimoles per liter (mmol/L) at admission. Individuals without measurement of serum albumin, urine ketone, or hemoglobin A1C, or harboring active infection, myocardial infarction, cerebrovascular event, cirrhosis, malignancy, or overt proteinuria were excluded. Using serum albumin concentration below 3.0 grams per deciliter to define hypoalbuminemia, 151 hypoalbuminemic cases and 104 normoalbuminemic controls were enrolled. The presence of ketones in urine established ketosis. Results. The prevalence of ketonuria was 48% in hypoalbuminemic subjects compared to 30% in normoalbuminemic controls (odds ratio (OR): 2.15; 95% confidence interval (CI): 1.26–3.57; P=0.004). Moreover, among the 156 subjects with serum beta-hydroxybutyrate measurement in addition to urine ketone, 33% of the hypoalbuminemic individuals had ketonemia exceeding 3 mmol/L compared to 19% of those with normoalbuminemia (OR: 2.12, 95% CI: 0.99–4.48, P=0.051). Conclusions. Serum albumin concentration is inversely associated with ketosis risk in hospitalized individuals with T2DM.http://dx.doi.org/10.1155/2016/1269706
spellingShingle Po-Chung Cheng
Shang-Ren Hsu
Yun-Chung Cheng
Association between Serum Albumin Concentration and Ketosis Risk in Hospitalized Individuals with Type 2 Diabetes Mellitus
Journal of Diabetes Research
title Association between Serum Albumin Concentration and Ketosis Risk in Hospitalized Individuals with Type 2 Diabetes Mellitus
title_full Association between Serum Albumin Concentration and Ketosis Risk in Hospitalized Individuals with Type 2 Diabetes Mellitus
title_fullStr Association between Serum Albumin Concentration and Ketosis Risk in Hospitalized Individuals with Type 2 Diabetes Mellitus
title_full_unstemmed Association between Serum Albumin Concentration and Ketosis Risk in Hospitalized Individuals with Type 2 Diabetes Mellitus
title_short Association between Serum Albumin Concentration and Ketosis Risk in Hospitalized Individuals with Type 2 Diabetes Mellitus
title_sort association between serum albumin concentration and ketosis risk in hospitalized individuals with type 2 diabetes mellitus
url http://dx.doi.org/10.1155/2016/1269706
work_keys_str_mv AT pochungcheng associationbetweenserumalbuminconcentrationandketosisriskinhospitalizedindividualswithtype2diabetesmellitus
AT shangrenhsu associationbetweenserumalbuminconcentrationandketosisriskinhospitalizedindividualswithtype2diabetesmellitus
AT yunchungcheng associationbetweenserumalbuminconcentrationandketosisriskinhospitalizedindividualswithtype2diabetesmellitus