Key result
Highest serum albumin quartile linked to ~41% lower all-cause mortality versus the lowest quartile.
Why the study?
There is little long-term data on the association between serum albumin levels and mortality in community-based populations.
Does the baseline serum albumin level predict all-cause and cerebro-cardiovascular mortality in a healthy community-based population?
Cohort (n=1,905)
No
Does the baseline serum albumin level predict all-cause and cerebro-cardiovascular mortality in a healthy community-based population?
Hazard Ratio: 0.59 (95% CI 0.39–0.88)
p-value: p=<0.01
Low serum albumin levels independently predict long-term all-cause and cerebro-cardiovascular mortality in a general community-based population.
Serum albumin may refine long-term mortality prediction in community settings; extends observational data to Japanese adults but leaves causality and interventions open.
Objective There is little long-term data on the association between the serum albumin levels and mortality in community-based populations. We aimed to determine whether the serum albumin level is an independent risk factor for all-cause and cause-specific death in a community-based cohort study in Japan. Methods In 1999, we performed a periodic epidemiological survey over a 15-year period in a population of 1,905 healthy subjects (783 males, 1,122 females) who were older than 40 years of age and who resided in Tanushimaru, a rural community, in Japan. Over the course of the study, we periodically examined the blood chemistry of the study subjects, including their serum albumin levels. Their baseline serum albumin levels were categorized into quartiles. Results The baseline albumin levels were significantly associated with age (inversely), body mass index (BMI), diastolic blood pressure, lipid profiles [high density lipoprotein-cholesterol (HDL-c), low-density lipoprotein-cholesterol (LDL-c) and triglycerides] and estimated glomerular filtration rate (eGFR). After adjusting for confounders, a Cox proportional hazards regression analysis demonstrated that a low serum albumin level was an independent predictor of all-cause death [hazard ratio (HR): 0.39, 95% confidence interval (CI): 0.24-0.65], cancer death (HR: 0.43, 95% CI: 0.18-0.99), death from infection (HR: 0.21, 95% CI: 0.06-0.73) and cerebro-cardiovascular death (HR: 0.19, 95% CI: 0.06-0.63). The HRs for all-cause and cerebro-cardiovascular death in the highest quartile vs. the lowest quartile of albumin after adjusting for confounders were 0.59 (95%CI:0.39-0.88) and 0.15 (95%CI: 0.03-0.66), respectively. Conclusion The serum albumin level was thus found to be a predictor of all-cause and cerebro-cardiovascular death in a general population.
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Umeki et al. (2016) conducted a cohort in Healthy subjects (general population) (n=1,905). Highest quartile of serum albumin (≥4.6 g/dL) vs. Lowest quartile of serum albumin (≤4.2 g/dL) was evaluated on All-cause mortality (HR 0.59, 95% CI 0.39-0.88, p=<0.01). In a general Japanese population, having serum albumin levels in the highest quartile was associated with a 41% lower risk of all-cause mortality (HR 0.59) compared to the lowest quartile over a 15-year period.
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