ArticleFrontiers in endocrinology2024
Unveiling the hidden risks: albumin-corrected anion gap as a superior marker for cardiovascular mortality in type 2 diabetes: insights from a nationally prospective cohort study.
Article in Frontiers in endocrinology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Association of ACAG with short-term mortality in liver failure patients: a retrospective analysis based on the MIMIC-IV database.Scientific reports · 2026Article
- Article
- Predictive Value of 48-hour Anion Gap Fluctuations in ICU Patients with Acute Kidney Injury: An Analysis based on MIMIC Database.Current pharmaceutical design · 2026Article
- Association Between Albumin-Corrected Anion Gap and Prevalent Prediabetes or Diabetes Mellitus: A Cross-Sectional Analysis of NHANES 2005-2010.Journal of diabetes research · 2026Article
- Association of albumin-corrected anion gap with all-cause and cardiovascular mortality in overactive bladder patients.Scientific reports · 2025Article
- Albumin-corrected anion gap and risk of mortality among US adults.Archives of public health = Archives belges de sante publique · 2025Article
- The Association Between Anion Gap and Albumin-Corrected Anion Gap with Sun Sensitivity: A National Retrospective Cross-Sectional Study.Clinical, cosmetic and investigational dermatology · 2025Article
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9 authors.
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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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