Serum Albumin and Mortality in the BUPA Study

Law, Malcolm; Morris, Joan K.; Wald, Nicholas; Hale, A K

doi:10.1093/ije/23.1.38

Cited by 48 publications

(36 citation statements)

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“…Positive associations between serum albumin levels and male sex, serum lipids and blood pressure, or inverse associations between serum albumin levels and age and smoking have been reported in previous studies [18][19][20] . Most, however, have considered serum albumin values only in relation to a few risk factors and did not adjust for possible confounders.…”

Section: Risk Factors For Cad and Acute-phase Proteins 957supporting

confidence: 56%

Risk factors for coronary heart disease and acute-phase proteins. A population-based study

Danesh¹

1999

European Heart Journal

210

130

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Aims Circulating levels of C-reactive protein and serum amyloid A protein increase markedly, and albumin levels fall, during the acute-phase response to tissue injury, infection and inflammation. Some acute-phase proteins have been associated with increased risks of coronary heart disease in long-term prospective studies. The aim of the present study was to determine whether circulating concentrations of C-reactive protein, albumin and serum amyloid A protein are correlated with one another, standard vascular risk factors, markers of persistent infection, or indicators of socio-economic status. Methods and ResultsWe report a cross-sectional study of 704 individuals without a history of coronary heart disease from five general practices in Bedfordshire, U.K. Plasma levels of C-reactive protein and serum amyloid A protein were strongly associated with each other (2P<0·00001) and inversely related to levels of serum albumin (2P<0·00001). There were highly significant associations of plasma C-reactive protein concentrations with cigarette smoking and obesity (2P<0·00001 for each). Serum albumin levels were strongly associated with blood pressure (2P<0·0001) and plasma lipids (2P<0·001), and concentrations of serum amyloid A protein were strongly correlated with obesity (2P<0·0001). ConclusionPreviously reported long-term prospective studies have found an increased risk of coronary heart disease of about 50% in people with raised baseline levels of plasma C-reactive protein or low albumin. The strong cross-sectional associations we have found between levels of these proteins with each other and with concentrations of serum amyloid A protein suggest that some underlying process related to inflammation is likely to be of relevance to the causation of disease. Further studies are needed to determine if the strong associations of plasma levels of C-reactive protein with cigarette smoking and obesity indicate that this particular protein can mediate some of the effects of those risk factors on coronary heart disease. (Eur Heart J 1999; 20: 954-959)

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Section: Risk Factors For Cad and Acute-phase Proteins 957supporting

confidence: 56%

Risk factors for coronary heart disease and acute-phase proteins. A population-based study

Danesh¹

1999

European Heart Journal

210

130

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“…Accordingly several epidemiological studies have reported an increased risk of cancer mortality associated with low serum albumin concentrations (Phillips et al, 1989;Law et al, 1994). The results from one study on incidence of colon cancer was also in line with the hypothesis of a protective effect (Ko et al, 1994), whereas another study reported elevated serum albumin levels in patients with future colon cancer (Stevens et al, 1994).…”

Section: Introductionmentioning

confidence: 58%

Serum albumin and colorectal cancer risk

et al. 2000

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Objective: To study the relationship between serum albumin and colorectal cancer occurrence. Design: A case ± control study nested within a cohort followed from 1968 to 1991. Subjects and methods: The albumin concentration was determined from serum samples stored at À20 C at baseline in 177 incident colorectal cancer cases and 288 controls matched for sex, age and study region. Results: An elevated risk was present of cancer of the left, distal colon at high serum albumin concentrations. No signi®cant association was observed for the right, proximal colon or the rectum. The relative risks of cancer of the distal and proximal colon among individuals in the highest and lowest quartiles of serum albumin were 17.03 (95% con®dence interval 1.48 ± 195) and 0.77 (95% con®dence interval 0.19 ± 3.13), respectively. Conclusions: The present study lends support to the hypothesis that some dietary factor associated with serum albumin may be a risk factor for distal colon cancer. Sponsorship: This study was supported by a grant from the Swedish Cancer Foundation.

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“…10 -14 Previous studies have suggested that a lower concentration of serum albumin is associated with a 2-fold increased risk of total cardiovascular mortality, 6,10,[15][16][17] all-cause mortality, 10,15,16,18,19 and cancer mortality. 16,20 Contrary to these studies, Law et al 11 did not find evidence for an association between lower levels of serum albumin and mortality from cardiovascular disease or cancer.…”

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confidence: 93%

Serum Albumin and Risk of Myocardial Infarction and All-Cause Mortality in the Framingham Offspring Study

et al. 2002

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Background-Coronary disease remains the leading cause of death in the United States. The association between serum albumin and cardiovascular disease remains controversial. We used data collected prospectively from participants of the Framingham Offspring Study to assess whether a lower concentration of serum albumin was associated with an increased risk of myocardial infarction (MI) and all-cause mortality. Methods and Results-During 21.9 years of mean follow-up, 280 cases of MI occurred. From the highest to the lowest tertile of serum albumin, crude incidence rates of MI were 26.7, 46.7, and 67.8 cases per 10 000 person-years, respectively, for men and 5.9, 15.0, and 16.8 cases per 10 000 person-years, respectively, for women. In a Mantel-Haenszel method adjusting for age, total cholesterol, and hypertension, lower serum albumin was associated with an increased risk of MI in both sexes. From the highest to the lowest tertile of albumin, the adjusted hazard ratios (95% CI) of MI were 1.0 (reference), 1.25 (0.84 to 1.84), and 1.49 (1.01 to 2.21), respectively, for men and 1.0, 1.79 (0.88 to 3.65), and 2.12 (1.06 to 4.27), respectively, for women. The albumin-MI association was stronger among hypertensive subjects in both sexes. In addition, low albumin was associated with an increased rate of all-cause mortality in women. Conclusions-Lower serum albumin concentrations appear to be associated with an increased risk of coronary disease in both sexes and with all-cause mortality in women and could help along with traditional risk factors in identifying people at risk of MI.

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Serum Albumin and Mortality in the BUPA Study

Cited by 48 publications

References 0 publications

Risk factors for coronary heart disease and acute-phase proteins. A population-based study

Risk factors for coronary heart disease and acute-phase proteins. A population-based study

Serum albumin and colorectal cancer risk

Serum Albumin and Risk of Myocardial Infarction and All-Cause Mortality in the Framingham Offspring Study

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