Causes and mechanisms of hypoalbuminaemia

Ballmer, PE

doi:10.1054/clnu.2001.0439

Cited by 185 publications

(133 citation statements)

References 5 publications

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“…Serum albumin level has shown to be a marker of disease severity [13], and hypoalbuminemia is associated with the presence of a systemic inflammatory response and weight loss [14,15]. The present study's findings are consistent with previous studies linking poor nutritional status with an adverse postoperative course in patients undergoing surgical treatment for colorectal cancer [16,17].…”

Section: Resultssupporting

confidence: 91%

Pre-operative Serum Albumin and Neutrophil-Lymphocyte Ratio are Associated with Prolonged Hospital Stay Following Colorectal Cancer Surgery

Gohil

Rishi

Tan

2014

BJMMR

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Aims-Colorectal cancer is the third most common cancer in European populations. It has been shown previously that neutrophil-lymphocyte ratio (NLR), pre-operative albumin, and haemoglobin are useful prognostic indicators. The aim of this study was to assess how these factors influence the length of postoperative stay (LOS) following colorectal cancer surgery.Methodology-All patients undergoing elective colorectal resections for malignancy between 2010 and 2011 in Pilgrim Hospital, Boston, U.K. were considered for the study. Hospital archive systems were used to ascertain pre-operative NLR, albumin and haemoglobin levels. LOS was calculated from electronic discharge documents with day 1 being the day after surgery. Unifactorial and multifactorial analyses were performed to identify independent predictors of prolonged stay Results-196 patients were included in the study. Pre-operative haemoglobin was not associated with prolonged hospital stay. On univariate analysis, pre-operative serum albumin and preoperative NLR were associated with prolonged hospital stay. On multivariate analysis, preoperative serum albumin >34.5 g/dl (odds ratio, 0.47; 95% confidence interval, 0.24 -0.92; p = 0.027) retained independent association for prolonged hospital stay .However, pre-operative NLR failed to reach statistical significance on multivariate analysis.Conclusions-Patients with low albumin and elevated NLR are more likely to have an increased hospital stay following colorectal cancer surgery. This may be useful for surgeons in terms of identifying the 'high-risk' patient post-operatively and allow for early intervention. *Corresponding author: benjamintan@hotmail.co.uk. AUTHORS' CONTRIBUTIONSBT designed the study and performed the statistical analysis. RG collected the data, managed the analyses of the study and wrote the first draft of the manuscript. MR collected the data, managed the analyses of the study. All authors read and approved the final manuscript. COMPETING INTERESTSAuthors have declared that no competing interests exist. Europe PMC Funders Group

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Section: Resultssupporting

confidence: 91%

Pre-operative Serum Albumin and Neutrophil-Lymphocyte Ratio are Associated with Prolonged Hospital Stay Following Colorectal Cancer Surgery

Gohil

Rishi

Tan

2014

BJMMR

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“…Our data show that the most significant metabolic changes observed in this study in both lean and diabetic rats were specifically related to LPS treatment. In agreement with previous reports, these metabolic changes in response to stress included an alteration in protein metabolism [32], inflammation (as reflected by hypoalbuminaemia) [33], and alterations in immune status (as reflected by thymic involution and spleen hypertrophy, which are a consequence of the redistribution of lymphocytes to the lymphoid organs and the gastrointestinal tract) [12,34]. In our work, endotoxaemia led to myofibrillar protein catabolism, since the urinary 3-MH:creatinine ratio increased.…”

Section: Effect Of Food Restrictionsupporting

confidence: 91%

The equivocal metabolic response to endotoxaemia in type 2 diabetic and obese ZDF rats

et al. 2006

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Aims/hypothesis: The metabolic and endocrine disturbances associated with obesity and type 2 diabetes may impair the normal metabolic response to injury. Our objective was to investigate amino acid metabolism in endotoxaemic type 2 diabetic obese rats. Materials and methods: A metabolic study was performed over 4 days using male Zucker diabetic fatty (ZDF) rats (fa/fa) and lean littermates (fa/+) divided into three groups: ad libitum-fed groups which underwent no treatment, lipopolysaccharide (LPS)-treated groups receiving E. coli LPS by i.p. injection, and pair-fed groups to the respective LPS groups. We evaluated the effect of endotoxaemia on body weight, food intake and tissue weights. Nitrogen loss and muscular proteolysis were measured daily by determination of urinary 3-methylhistidine (3-MH) excretion. Plasma, intestine and muscle amino acid levels were measured. Results: The data showed that ad libitum-fed ZDF rats had lower plasma arginine and glutamine levels than ad libitum-fed control rats. Compared with control rats, the LPS-treated ZDF rats presented lower thymic involution, a lower 3-MH:creatinine ratio and higher cumulative nitrogen balance. Conclusions/interpretation: Against our working hypothesis, ZDF rats did not show an impaired metabolic response, and even appeared to be less sensitive to the stress.

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“…Increased level of C-reactive protein (CRP) is independent risk factor for stroke (Rost et al, 2001;Cao et al, 2003). Systemic inflammation causes a fall of albumin concentration by reducing synthesis of proteins and increasing their catabolic state (Ballmer, 2001). In our study, hypoalbuminemia was accompanied by increased level of a-, b-, g-globulin, the pattern typical for inflammation.…”

Section: Hypoalbuminemia In Acute Ischemic Stroke Patients T Dziedzicmentioning

confidence: 99%

Hypoalbuminemia in acute ischemic stroke patients: frequency and correlates

et al. 2007

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Objective: Hypoalbuminemia in acute stroke patients is associated with increased mortality and morbidity. The aim of our study was to determine the frequency and correlates of hypoalbuminemia in unselected cohort of patients with acute cerebral infarction. Design: Prospective study. Setting: University hospital. Subjects: Seven hundred and five consecutive ischemic stroke patients. Methods: Albumin and other serum protein fractions were measured within 36 h after stroke using electrophoresis. Results: Hypoalbuminemia defined as serum albumin level o35 g/l was found in 45.5% of patients. Serum albumin level correlates significantly with age (r ¼ À0.13, Po0.01), Scandinavian Stroke Scale score (r ¼ 0.14, Po0.01), body temperature on admission (r ¼ 0.14, Po0.01), leukocyte count (r ¼ À0.17, Po0.01), fasting glucose (r ¼ À0.16, Po0.01), total cholesterol (r ¼ 0.14, Po0.01), a1-globulin (r ¼ À0.48, Po0.01), a2-globulin (r ¼ À0.49, Po0.01), b-globulin (r ¼ À0.26, Po0.01) and g-globulin (r ¼ À0.35, Po0.01). Conclusions: Hypoalbuminemia is a frequent finding in acute stroke patients and it is associated with more severe stroke and pro-inflammatory pattern of serum protein electrophoresis.

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Causes and mechanisms of hypoalbuminaemia

Cited by 185 publications

References 5 publications

Pre-operative Serum Albumin and Neutrophil-Lymphocyte Ratio are Associated with Prolonged Hospital Stay Following Colorectal Cancer Surgery

Pre-operative Serum Albumin and Neutrophil-Lymphocyte Ratio are Associated with Prolonged Hospital Stay Following Colorectal Cancer Surgery

The equivocal metabolic response to endotoxaemia in type 2 diabetic and obese ZDF rats

Hypoalbuminemia in acute ischemic stroke patients: frequency and correlates

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