Importantly, in the randomized clinical trial, the Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiency (STAMPEDE) study, patients with diabetes receiving bariatric surgery had reduced urine albumin–creatinine ratio of − 3.0 mg/g in the gastric bypass group and − 5.0 mg/g in the sleeve gastrectomy group compared with − 1.0 mg/g in the medical group (P = 0.03 and P = 0.002 respectively) [10]. Here, ALB is linked to diabetes mellitus.