AI Article Synopsis
- The study investigated the relationship between albumin-corrected serum anion gap (ACAG) levels and various mortality outcomes in type 2 diabetes (T2D) patients, indicating that hypoalbuminemia could underestimate true anion gap levels.
- Using data from 8,161 diabetic adults over 20 years, the research found that higher ACAG levels correlated with increased rates of all-cause mortality, as well as cardiovascular and cancer-specific mortality.
- The analysis also highlighted that certain factors, such as C-reactive protein and cholesterol levels, partially mediated the connection between ACAG levels and mortality risks, suggesting that maintaining normal ACAG levels could lower mortality risks for individuals with T2D.
Article Abstract
Aims: Hypoalbuminemia can lead to underestimations of the true anion gap levels. There are few data on albumin-corrected serum anion gap (ACAG) status and mortality in the diabetes. The study aimed to examine the association between ACAG and all-cause, cardiovascular, and cancer mortality in type 2 diabetes (T2D) patients.
Methods: Herein, 8,161 diabetic adults were included in the National Health and Nutrition Examination Survey (NHANES) 1999-2018. National Mortality Index (NDI) data were used for determining mortality outcomes through 31 December 2019. Cox proportional hazards models were used to estimate the risk of all-cause, cardiovascular, and cancer mortality. We conducted a mediation analysis using the counterfactual framework method to estimate how ACAG may be indirectly associated with increased mortality risk through mediators.
Results: A total of 2,309 deaths were documented over 8,161 person-years of follow up, including 659 cardiovascular and 399 cancer deaths. In multivariate analyses, higher ACAG levels had a significant correlation with an increase in all-cause (HR, 1.58; 95% CI, 1.38-1.81; P=0.001), cardiovascular (HR, 1.34; 95% CI, 1.05-1.72; P=0.019), and cancer (HR, 1.41; 95% CI, 1.02-1.96; P=0.018) mortality rates than the controls. Results of the mediation analysis showed that altered levels of C-reactive protein and estimated glomerular filtration rate (eGFR) explained 7.867% and 7.669% of the relation between serum ACAG and all-cause mortality, respectively (all P<0.05). Total cholesterol and HbA1c mediated 15.402% and 14.303% of the associations with cardiovascular mortality, respectively (all P<0.05).
Conclusions: Higher ACAG levels were significantly associated with increased all-cause, cardiovascular, and cancer mortality. Researchers suggest that patients with T2D who control ACAG in a normal state may be at a lower risk of mortality.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11578733 | PMC |
| http://dx.doi.org/10.3389/fendo.2024.1461047 | DOI Listing |
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