ALB and metabolic disease: Serum albumin is not only a marker of nutritional status but also reduces oxidative stress by scavenging free radicals, a central driver of insulin resistance and β-cell dysfunction.[26] Albumin deficiency can exacerbates diabetic complications by worsening insulin resistance, metabolic disorders, and reducing the body’s defense against oxidative stress.[27,28] Low albumin levels can also worsen lipid metabolism disorders and further promote diabetic microangiopathy by reducing lipocalin expression.[29,30] Second, the immunoprotective role of lymphocytes.