First, the design of the study was limited in that not all patients obtained serum albumin values at the same time interval and the etiology of low albumin levels was not distinguished; Second, some of the covariates selected for this study such as smoking, drinking, hypertension, and diabetes were obtained in combination with subjective questionnaires, which may bias the results; Third, our study was conducted on patients in the general U.S. population, so it is not clear whether the J-shaped predictive effect of albumin is also applicable to other populations or ethnic groups. Here, ALB is linked to diabetes mellitus.