In contrast to subjects in quartile 1 (8.42–8.70 mg/dL), there were significantly increased risk of HFpEF with subjects in quartile 4 [(9.23–10.42 mg/dL), OR (95 % CI) = 2.331 (1.088–4.994), p = 0.029], after adjusted for possible confounding factors including age, gender and obesity in model 1, further adjusted for smoking, hypertension, and dyslipidemia in model 2, and furthermore adjusted for LVMI, lg Alb/Cr, lg HOMA-IR and uric acid in model 3. This evidence concerns the gene ALB and metabolic syndrome.