Evidence map›Paper›PMID 42818664›Full record

ArticleFrontiers in endocrinology2026

Sex-specific threshold effect of albumin-corrected fructosamine on diabetic retinopathy: a nonlinear relationship in women but linear in men - a cross-sectional study.

Qiyun Long, Shuang Kang, Qiyao He, Huaguo Wang, Xing Qi, Sheng Lin, Xuhui Song, Qin Guo, Zejiang Liu

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Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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9 authors.

Qiyun LongDepartment of Clinical Laboratory Medicine, Ziyang Central Hospital, Ziyang, China.
Shuang KangDepartment of Clinical Laboratory Medicine, Ziyang Central Hospital, Ziyang, China.
Qiyao HeDepartment of Clinical Laboratory Medicine, Ziyang Central Hospital, Ziyang, China.
Huaguo WangDepartment of Clinical Laboratory Medicine, Ziyang Central Hospital, Ziyang, China.
Xing QiDepartment of Clinical Laboratory Medicine, Ziyang Central Hospital, Ziyang, China.
Sheng LinDepartment of Clinical Laboratory Medicine, Ziyang Central Hospital, Ziyang, China.
Xuhui SongDepartment of Clinical Laboratory Medicine, Ziyang Central Hospital, Ziyang, China.
Qin GuoDepartment of Clinical Laboratory Medicine, Ziyang Central Hospital, Ziyang, China.
Zejiang LiuDepartment of Clinical Laboratory Medicine, Ziyang Central Hospital, Ziyang, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Albumin-corrected fructosamine (AlbF) is a short-term glycemic marker that can substitute for HbA1c when HbA1c is unreliable. Studies have linked AlbF to diabetic retinopathy (DR), but it is not known whether the dose-response curve differs between men and women. We investigated this in 1,090 type 2 diabetes patients (433 men, 657 women) from a single Chinese center. Methods: Restricted cubic splines were used to model the AlbF-DR relationship separately by sex, with threshold identification via segmented logistic regression. Models included age, BMI, diabetes duration, systolic blood pressure, HbA1c, HDL-C, and medications as covariates. Results: Each 10 μmol/g increase in AlbF raised DR risk in both sexes: men OR 1.83 (95% CI 1.39-2.41), women OR 1.58 (95% CI 1.26-1.99). The RCS curves told a different story. Men followed a linear pattern (P for nonlinearity = 0.751). Women showed a threshold near 62.0 μmol/g (P for nonlinearity < 0.001). Below that value, the OR was 2.57 (95% CI 1.74-3.81); above it, the association was no longer significant (OR 1.29, 95% CI 0.69-2.42; P for interaction < 0.001). Sensitivity analyses consistently reproduced this nonlinear pattern. Conclusions: The AlbF-DR relationship is linear in men but follows a threshold model in women, with a change point near 62.0 μmol/g. Sex-specific risk modeling may improve DR stratification. Whether the threshold holds in practice will require prospective studies.

Indexed as

Diabetes Mellitus, Type 2Diabetic RetinopathyFructosamineSerum AlbuminAgedBiomarkersBlood GlucoseCross-Sectional StudiesFemaleGlycated HemoglobinHumansMaleMiddle AgedSex CharacteristicsSex FactorsBiomarkersBlood GlucoseFructosamineGlycated HemoglobinSerum Albuminalbumin-corrected fructosaminediabetic retinopathyrestricted cubic splinessegmented regressionsex differencesthreshold effect

Identifiers

PMID42818664
PMCPMC13623703

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