A Study of the Relationship Between Serum Albumin-Corrected Fructosamine and Type 2 Diabetic Retinopathy

To examine the association between albumin-corrected fructosamine (AlbF) levels and the presence of diabetic retinopathy (DR) in adults with Type 2 diabetes mellitus (T2DM).

This cross-sectional study retrospectively analyzed 1263 inpatients with T2DM. After applying exclusion criteria, 415 patients were included and categorized into DR (n = 174) and non-DR (n = 241) groups based on fundus examination. The association between the AlbF-analyzed both continuously (per 10 μmol/g increment) and categorically (by tertiles)-and DR was assessed using multivariable logistic regression with progressive adjustment for sociodemographic, clinical, and laboratory confounders. Supplementary analyses, including receiver operating characteristic (ROC) curve assessment and interaction testing across predefined subgroups, evaluated the association's robustness and consistency.

The prevalence of DR was 41.9%. Following full adjustment, each 10 μmol/g increment in AlbF was associated with higher odds of having DR (adjusted OR = 1.88, 95% CI: 1.36-2.60; p < 0.001). A significant dose-response relationship was observed (p for trend < 0.001), with patients in the highest AlbF tertile exhibiting 7.20 times the odds of DR (95% CI: 2.82-18.40) compared to the lowest tertile. Furthermore, the association remained consistent across all predefined subgroups (p for interaction > 0.05 for all).

Elevated AlbF was independently associated with the presence of DR in adults with T2DM, demonstrating a significant dose-response relationship. AlbF shows promise as a biomarker candidate for DR identification and stratification. Its potential clinical utility requires validation in larger prospective studies.