Abstract:Objective To investigate the clinical value of prealbumin (PA) in middle-aged and elderly newly-diagnosed diabetic patients and its influencing factors. Methods A total of 538 patients (≥45 years old) with newly diagnosed diabetes in our department from January 2010 to December 2012 were recruited in this study. They were divided into 4 groups according to the quartiles of their PA levels, and received routine physical examination and biochemical tests, including body mass index (BMI), blood pressure, fasting blood glucose, hemoglobin (Hgb), liver and kidney functions, lipid profile, fasting C-peptide, glycosylated hemoglobin (HbAlc), glycosylated albumin (GA), C-reactive protein (CRP), etc. Results The PA level in this cohort was significantly higher in the males than in the females [(239±55) vs (227±53)mg/L, P<0.01] and in a trend of decrease with the increase of age (P<0.05). As the PA rose, the BMI, waist circumference, diastolic blood pressure (DBP), Hgb, albumin, γ-glutamyl transpeptidase, total bilirubin, total cholesterol (TC), triglycerides (TG), creatinine, uric acid (UA) and fasting C-peptide were increased (P<0.05), but the age, HbA1c, GA and CRP were decreased (P<0.05). After controlling age, gender and BMI, partial correlation analysis showed that PA was positively correlated with Hgb, albumin, TC, TG, creatinine, UA and fasting C-peptide (all P<0.01), but negatively correlated with HbA1c, GA and CRP (P<0.01). The prevalence of hypo-prealbuminemia (defined as PA <200mg/L) was 27.7% in the cohort. Multivariate logistic regression showed that the GA (OR=1.056, 95%CI=1.021?1.092, P<0.01) and CRP levels (OR=1.273, 95%CI=1.092?1.485, P<0.01) were independent risk factors, while Hgb (OR=0.978, 95% CI=0.961?0.997, P=0.02), albumin (OR=0.738, 95% CI=0.668?0.815, P<0.01), TC (OR=0.747, 95%CI=0.561?0.994; P=0.045) and fasting C-peptide (OR=0.678, 95%CI=0.504?0.911, P=0.01) were protective factors for hypo-prealbuminemia in middle-aged and elderly newly-diagnosed diabetic patients. The cutoff values of PA for the hypo-prealbuminemia deduced by receiver operating characteristic (ROC) curve were 25%, the area under the ROC curve was 0.686 (95% CI=0.638?0.735, P<0.01), and its sensitivity was 76.4% and specificity 53.4%. Conclusion PA level is affected by nutrition status, inflammatory status, blood glucose and serum lipids in middle-aged and elderly newly-diagnosed diabetic patients. The low level of PA in the subjects might be due to their increased blood glucose.