1Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea.
2Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
4Department of Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
5Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
6Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea.
Copyright © 2018 Korean Diabetes Association
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CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.
Values are presented as number (%), median (interquartile range), or mean±standard deviation.
L, lower; H, higher; MetS, metabolic syndrome; BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; HbA1c, glycosylated hemoglobin; HOMA2-IR, homeostatic model assessment index 2 for insulin resistance; TG, triglyceride; LDL-C, low density lipoprotein cholesterol; HDL-C, high density lipoprotein cholesterol; AST, aspartate aminotransferase; ALT, alanine aminotransferase; hs-CRP, high-sensitivity C-reactive protein.
Baseline serum albumin aL (3.1 to 4.3 g/dL in males, 3.2 to 4.2 g/dL in females), bH (4.4 to 5.2 g/dL in males, 4.3 to 5.1 g/dL in females); Baseline serum uric acid cL (0.7 to 5.8 mg/dL in males, 0.5 to 4.1 mg/dL in females), dH (5.9 to 12.1 mg/dL in males, 4.2 to 7.7 mg/dL in females), e,f,g,hDifferent superscript letters imply significantly different values by the post hoc analysis (Tukey's multiple comparison test following a one-way analysis of variance or Mann-Whitney U test using Bonferroni correction following the Kruskal-Wallis test).
BMI, body mass index; BP, blood pressure; HbA1c, glycosylated hemoglobin; HOMA2-IR, homeostatic model assessment index 2 for insulin resistance; TG, triglyceride; LDL-C, low density lipoprotein cholesterol; HDL-C, high density lipoprotein cholesterol; hs-CRP, high-sensitivity C-reactive protein.
aSerum albumin (g/dL), bSerum uric acid (mg/dL).
Values are presented as HR (95% CI).
HR, hazard ratio; CI, confidence interval; L, lower; H, higher; MetS, metabolic syndrome.
Baseline serum albumin aL (3.1 to 4.3 g/dL in males, 3.2 to 4.2 g/dL in females), bH (4.4 to 5.2 g/dL in males, 4.3 to 5.1 g/dL in females); Baseline serum uric acid cL (0.7 to 5.8 mg/dL in males, 0.5 to 4.1 mg/dL in females), dH (5.9 to 12.1 mg/dL in males, 4.2 to 7.7 mg/dL in females), eAdjusted for age, body mass index, waist circumference, systolic blood pressure, alanine aminotransferase, estimated glomerular filtration rate, fasting glucose, smoking status, medication (statin and aspirin), baseline diabetes mellitus prevalence, low density lipoprotein cholesterol, and high-sensitivity C-reactive protein, fAdjusted for Model 1+alcohol history (n=9,483), gAdjusted for Model 1+homeostasis model assessment index 2 for insulin resistance (n=6,908).
Characteristic | Four groups categorized by sex-specific medians of baseline serum albumin and uric acid | P value | |||
---|---|---|---|---|---|
Group 1 (n=3,468) | Group 2 (n=2,779) | Group 3 (n=2,758) | Group 4 (n=2,608) | ||
Baseline serum | |||||
Albumin | La | Hb | La | Hb | |
Uric acid | Lc | Lc | Hd | Hd | |
Sex | |||||
Male | 2,101 (60.6) | 1,554 (55.9) | 1,691 (61.3) | 1,544 (59.2) | |
Female | 1,367 (39.4) | 1,225 (44.1) | 1,067 (38.7) | 1,064 (40.8) | |
Incidence of MetS | 545 (15.7) | 493 (17.7) | 702 (25.5) | 699 (26.8) | <0.001 |
Median serum albumin, g/dL | 4.20 (4.00–4.20) | 4.50 (4.40–4.60) | 4.20 (4.10–4.20) | 4.50 (4.40–4.60) | |
Median serum uric acid, mg/dL | 4.30 (3.60–5.20) | 4.10 (3.60–5.20) | 6.10 (4.90–6.80) | 6.10 (4.90–6.80) | |
Age, yr | 51.9±8.2e | 49.5±7.6f | 52.2±8.2e | 49.8±8.0f | <0.001 |
Waist circumference, cm | 80.4±8.2e | 79.5±8.5f | 82.6±8.4g | 82.0±8.4h | <0.001 |
In men | 84.8±6.3e | 84.6±6.3e | 86.8±6.1f | 86.6±6.1f | <0.001 |
In women | 73.7±6.0e | 73.0±6.1f | 75.9±6.9g | 75.3±6.6g | <0.001 |
BMI, kg/m2 | 22.92±2.38e | 22.62±2.50f | 23.70±2.48g | 23.51±2.50h | <0.001 |
Smoking status | |||||
Current smoker | 599 (17.3) | 397 (14.3) | 509 (18.5) | 412 (15.8) | 0.531 |
Ex-smoker | 993 (28.6) | 743 (26.7) | 837 (30.3) | 764 (29.3) | |
Never-smoker | 1,876 (54.1) | 1,639 (59.0) | 1,412 (51.2) | 1,432 (54.9) | |
Systolic BP, mm Hg | 108.0 (100.0–118.0)e | 111.0 (101.0–120.0)f | 110.0 (100.0–120.0)g | 112.0 (102.0–121.0)f | <0.001 |
Diastolic BP, mm Hg | 67.0 (60.0–74.0)e | 70.0 (61.0–75.0)f | 68.0 (60.0–75.0)g | 70.0 (62.0–77.0)h | <0.001 |
eGFR, mL/min/1.73 m2 | 90.10±11.89e | 92.19±12.23f | 85.48±11.27g | 87.18±11.74h | <0.001 |
Fasting glucose, mg/dL | 86.0 (81.0–92.0)e | 87.0 (82.0–93.0)f | 86.0 (81.0–92.0)e | 87.0 (82.0–93.0)f | <0.001 |
HbA1c, % | 5.37±0.60 | 5.36±0.54 | 5.34±0.41 | 5.35±0.40 | 0.343 |
Fasting insulin, μU/mL | 7.50 (6.00–9.60)e (n=2,078) | 8.00 (6.10–10.10)f (n=1,589) | 7.90 (6.20–10.20)f (n=1,735) | 8.20 (6.30–10.60)f (n=1,506) | <0.001 |
HOMA2-IR | 1.00 (0.80–1.20)e (n=2,078) | 1.00 (0.80–1.30)f,g (n=1,589) | 1.00 (0.80–1.30)f (n=1,735) | 1.10 (0.80–1.40)g (n=1,506) | <0.001 |
Total cholesterol, mg/dL | 183.9±30.2e | 192.0±31.4f | 188.3±30.7g | 199.4±32.3h | <0.001 |
TG, mg/dL | 91.0 (69.0–122.0)e | 95.0 (71.0–127.0)f | 101.0 (76.0–136.0)g | 106.0 (79.0–142.0)h | <0.001 |
LDL-C, mg/dL | 117.5±27.1e | 122.6±27.8f | 122.6±27.7f | 130.8±29.4g | <0.001 |
HDL-C, mg/dL | 59.5±13.4e | 61.6±14.1f | 57.9±12.8g | 59.3±13.3e | <0.001 |
Baseline bilirubin, mg/dL | 0.86±0.32e | 0.94±0.33f | 0.87±0.33e | 0.94±0.33f | <0.001 |
AST, U/L | 20.0 (17.0–23.0)e | 21.0 (18.0–25.0)f | 21.0 (18.0–25.0)f | 22.0 (19.0–26.0)g | <0.001 |
ALT, U/L | 17.0 (13.0–22.0)e | 18.0 (14.0–25.0)f | 18.0 (14.0–25.0)f | 20.0 (16.0–27.8)g | <0.001 |
hs-CRP, mg/L | 0.11±0.35e | 0.08±0.25f | 0.14±0.53g | 0.09±0.16h | <0.001 |
Variable | Serum uric acid | Serum albumin | ||
---|---|---|---|---|
Pearson's correlation coefficient (r) | P value | Pearson's correlation coefficient (r) | P value | |
Serum albumin, g/dLa or uric acid, mg/dLb | 0.160a | <0.001a | 0.160b | <0.001b |
Waist circumference, cm | 0.517 | <0.001 | 0.083 | <0.001 |
BMI, kg/m2 | 0.367 | <0.001 | 0.023 | 0.012 |
Systolic BP, mm Hg | 0.115 | <0.001 | 0.137 | <0.001 |
Diastolic BP, mm Hg | 0.187 | <0.001 | 0.151 | <0.001 |
Fasting glucose, mg/dL | 0.056 | <0.001 | 0.095 | <0.001 |
HbA1c, % | 0.030 | 0.001 | 0.016 | 0.086 |
HOMA2-IR (n=6,908) | 0.081 | <0.001 | 0.071 | <0.001 |
Total cholesterol, mg/dL | 0.053 | <0.001 | 0.176 | <0.001 |
TG, mg/dL | 0.268 | <0.001 | 0.118 | <0.001 |
LDL-C, mg/dL | 0.139 | <0.001 | 0.159 | <0.001 |
HDL-C, mg/dL | −0.265 | <0.001 | 0.009 | 0.342 |
hs-CRP, mg/L | 0.056 | <0.001 | −0.070 | <0.001 |
Variable | Four groups categorized by sex-specific medians of baseline serum albumin and uric acid | |||
---|---|---|---|---|
Group 1 (n=3,468) | Group 2 (n=2,779) | Group 3 (n=2,758) | Group 4 (n=2,608) | |
Baseline serum | ||||
Albumin | La | Hb | La | Hb |
Uric acid | Lc | Lc | Hd | Hd |
Median serum albumin, g/dL | 4.20 (4.00–4.20) | 4.50 (4.40–4.60) | 4.20 (4.10–4.20) | 4.50 (4.40–4.60) |
Median serum uric acid, mg/dL | 4.30 (3.60–5.20) | 4.10 (3.60–5.20) | 6.10 (4.90–6.80) | 6.10 (4.90–6.80) |
Incidence of MetS | 545 (15.7) | 493 (17.7) | 702 (25.5) | 699 (26.8) |
Crude model | 1 (reference) | 1.162 (1.029–1.313) (P=0.015) | 1.667 (1.491–1.865) (P<0.001) | 1.814 (1.622–2.029) (P<0.001) |
1 (reference) | 1.437 (1.280–1.612) (P<0.001) | 1.562 (1.392–1.753) (P<0.001) | ||
1 (reference) | 1.086 (0.978–1.206) (P=0.123) | |||
Model 1e | 1 (reference) | 1.143 (1.010–1.294) (P=0.034) | 1.386 (1.236–1.554) (P<0.001) | 1.476 (1.312–1.660) (P<0.001) |
1 (reference) | 1.242 (1.101–1.401) (P<0.001) | 1.314 (1.167–1.480) (P<0.001) | ||
1 (reference) | 1.069 (0.959–1.193) (P=0.228) | |||
Model 2f | 1 (reference) | 1.165 (1.014–1.337) (P=0.031) | 1.451 (1.275–1.650) (P<0.001) | 1.553 (1.361–1.771) (P<0.001) |
1 (reference) | 1.278 (1.118–1.461) (P<0.001) | 1.352 (1.186–1.542) (P<0.001) | ||
1(reference) | 1.076 (0.953–1.215) (P=0.235) | |||
Model 3g | 1 (reference) | 1.091 (0.926–1.287) (P=0.297) | 1.366 (1.176–1.587) (P<0.001) | 1.427 (1.219–1.669) (P<0.001) |
1 (reference) | 1.283 (1.096–1.503) (P=0.002) | 1.312 (1.118–1.539) (P=0.001) | ||
1 (reference) | 1.022 (0.885–1.181) (P=0.765) |
Values are presented as number (%), median (interquartile range), or mean±standard deviation. L, lower; H, higher; MetS, metabolic syndrome; BMI, body mass index; BP, blood pressure; eGFR, estimated glomerular filtration rate; HbA1c, glycosylated hemoglobin; HOMA2-IR, homeostatic model assessment index 2 for insulin resistance; TG, triglyceride; LDL-C, low density lipoprotein cholesterol; HDL-C, high density lipoprotein cholesterol; AST, aspartate aminotransferase; ALT, alanine aminotransferase; hs-CRP, high-sensitivity C-reactive protein. Baseline serum albumin aL (3.1 to 4.3 g/dL in males, 3.2 to 4.2 g/dL in females), bH (4.4 to 5.2 g/dL in males, 4.3 to 5.1 g/dL in females); Baseline serum uric acid cL (0.7 to 5.8 mg/dL in males, 0.5 to 4.1 mg/dL in females), dH (5.9 to 12.1 mg/dL in males, 4.2 to 7.7 mg/dL in females), e,f,g,hDifferent superscript letters imply significantly different values by the
BMI, body mass index; BP, blood pressure; HbA1c, glycosylated hemoglobin; HOMA2-IR, homeostatic model assessment index 2 for insulin resistance; TG, triglyceride; LDL-C, low density lipoprotein cholesterol; HDL-C, high density lipoprotein cholesterol; hs-CRP, high-sensitivity C-reactive protein. aSerum albumin (g/dL), bSerum uric acid (mg/dL).
Values are presented as HR (95% CI). HR, hazard ratio; CI, confidence interval; L, lower; H, higher; MetS, metabolic syndrome. Baseline serum albumin aL (3.1 to 4.3 g/dL in males, 3.2 to 4.2 g/dL in females), bH (4.4 to 5.2 g/dL in males, 4.3 to 5.1 g/dL in females); Baseline serum uric acid cL (0.7 to 5.8 mg/dL in males, 0.5 to 4.1 mg/dL in females), dH (5.9 to 12.1 mg/dL in males, 4.2 to 7.7 mg/dL in females), eAdjusted for age, body mass index, waist circumference, systolic blood pressure, alanine aminotransferase, estimated glomerular filtration rate, fasting glucose, smoking status, medication (statin and aspirin), baseline diabetes mellitus prevalence, low density lipoprotein cholesterol, and high-sensitivity C-reactive protein, fAdjusted for Model 1+alcohol history (