J. Karthikeyan and S. Rajaragupathy (2018). Diagnostic Usefulness of Serum Albumin as a Predictor of Diabetic Ketoacidosis. Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine, 22(10), 733-736. https://doi.org/10.4103/ijccm.IJCCM_91_18

PubMed 30405285

[Abstract]
CONTEXT: Diabetes mellitus is one of the most prevalent diseases worldwide. One of the acute complications of diabetes mellitus is diabetic ketoacidosis. It becomes essential for the healthcare physicians to identify the individuals who are likely to be prone to the development of ketosis. Serum albumin levels may be a cost-effective and simple parameter to prognosticate the risk of ketosis.

AIMS: This study was done to find a relationship between serum albumin levels and ketonuria.

SETTINGS AND DESIGN: After ethical approval, this prospective case-control study was carried out in patients diagnosed as type-2 diabetes mellitus.

SUBJECTS AND METHODS: Serum albumin levels were measured by bromo cresol green method. Measurement of urine ketones was done manually using dipsticks, a semi-quantitative manual method.

STATISTICAL ANALYSIS USED: Student's t-test was used to compare continuous variables and Chi-square test for categorical variables. Pearson's correlation was done to establish correlation.

RESULTS: In the normoalbuminemic group, 72% were ketones negative and only 28% had positive ketones in urine, while in the hypoalbuminemic group, 50.7% had negative urine ketones and 49.3% had positive ketonuria. The mean value for ketones in urine was 9.7 mg/dL in the hypoalbuminemic group, but it was only 4.3 mg/dL in the normoalbuminemic group. Pearson's correlation between serum albumin and urine ketone levels was performed and the r-value was found to be -0.305.

CONCLUSIONS: Serum albumin levels may predict the occurrence of ketosis in diabetic patients.