# Exploratory Analysis of Serum Oxidized Albumin as a Potential Prognostic Indicator for Diabetic Microvascular Complications: A Retrospective Cohort Pilot Study

## TL;DR

This study explores whether a blood marker called HNA% can predict the progression of diabetes-related complications over five years.

## Contribution

The study suggests that HNA% could serve as a novel prognostic indicator for diabetic retinopathy and kidney disease.

## Key findings

- Lower baseline HNA% was linked to improved retinopathy over five years, regardless of blood sugar levels.
- Higher baseline HNA% was associated with increased risk of CKD progression in diabetic patients.

## Abstract

Introduction

Oxidative stress is known to play a key role in the pathogenesis of diabetic complications. However, a useful biomarker of oxidative stress has not yet been widely adopted in clinical practice. We explored whether the ratio of serum oxidized albumin (human non-mercaptalbumin, HNA) to total albumin (HNA%) is associated with the five-year prognosis of diabetic complications.

Methods

In this single-center, retrospective cohort pilot study, we evaluated participants with diabetes who had been hospitalized at baseline and regularly followed up as outpatients. We measured the HNA% at baseline and at a five-year follow-up and assessed the development or progression of diabetic complications. We examined the relationship between baseline HNA% and changes in diabetic complications.

Results

In participants with simple diabetic retinopathy at baseline, lower baseline HNA% was associated with shorter duration of diabetes and with five-year improvement of retinopathy, irrespective of follow-up glycated hemoglobin levels (25.46% vs. 33.71%, p = 0.021). Additionally, in the overall cohort and in the subgroup with baseline chronic kidney disease (CKD) stage G2, baseline HNA% above the cutoff value was associated with increased risk of CKD progression (overall: RR 1.61, p = 0.042, stage G2 only: RR 1.83, p = 0.047). Regarding macrovascular complications, follow-up HNA%, but not baseline HNA%, was related to their development.

Conclusions

These exploratory findings suggest that HNA% may have potential as an indicator of the five-year prognosis of diabetic retinopathy and diabetic kidney disease. Further prospective studies are warranted to validate these findings.