Serum albumin levels predict vascular dysfunction with paradoxical pathogenesis in healthy individuals

• Published in: Atherosclerosis Vol. 209; no. 1; pp. 266 - 270
• Main Authors: Kadono, Mayuko, Hasegawa, Goji, Shigeta, Masako, Nakazawa, Atsuko, Ueda, Miho, Yamazaki, Masahiro, Fukui, Michiaki, Nakamura, Naoto
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.03.2010; Elsevier
• Subjects: Adult; Aged; Aged, 80 and over; Albumin; Atherosclerosis (general aspects, experimental research); Atherosclerosis - epidemiology; Biological and medical sciences; Blood and lymphatic vessels; Blood Vessels - physiopathology; Cardiology. Vascular system; Cardiovascular; Coronary heart disease; Cross-Sectional Studies; Female; Heart; Heart Rate; Humans; Hyperglycemia - blood; Inflammation; Inflammation - blood; Japan - epidemiology; Male; Medical sciences; Metabolic Syndrome - blood; Middle Aged; Overnutrition; Paradox; Pulse-wave velocity; Serum Albumin - analysis; Vascular function; Young Adult; Albumin; Pulse-wave velocity; Paradox; Inflammation; Vascular function; Overnutrition; Vascular disease; Pathogenesis; Atherosclerosis; Cardiovascular disease
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2009.09.006

Abstract Background Serum albumin is affected by both nutritional status and inflammation. It is, therefore, thought to be highly linked with pathogenesis of vascular dysfunction. Methods Cross-sectional data from 2091 individuals aged 23–87, who underwent a general health examination, were analyzed. First, we investigated the association between serum albumin level and vascular functions, as assessed by brachial-ankle pulse-wave velocity (PWV). Then, we evaluated the prevalence of hyperglycemia (fasting blood sugar ≥100 mg/dl), metabolic syndrome as determined by NCEP criteria, and inflammation (CRP ≥0.4 mg/dl), across tertiles of albumin levels. Results In a multivariate regression model, a U-shaped relationship between serum albumin and PWV was statistically significant when albumin level was treated as a continuous variable in g/dl and centered at 4.4 g/dl (quadratic term P -value = 0.006). The highest tertile of albumin level (4.6–5.4 g/dl) was associated with increased odds ratios for hyperglycemia of 1.35 (1.07–1.70) compared to the middle tertile (4.4–4.5 g/dl), whereas the lowest tertile (3.3–4.3 g/dl) was associated with reduced odds ratios for hyperglycemia of 0.80 (0.65–0.99). The highest tertile was also associated with increased odds ratios for metabolic syndrome of 1.30 (0.96–1.76) compared to the middle tertile, whereas the lowest tertile was associated with reduced odds ratios of 0.70 (0.51–0.95). Furthermore, the lowest tertile was associated with increased prevalence of inflammation with an adjusted odds ratio of 1.85 (1.15–2.97). Conclusions The current results demonstrate that extremes of serum albumin levels are linked to vascular dysfunction among healthy individuals. Furthermore, serum albumin is paradoxically linked to vascular disease under conditions both of overnutrition and of malnutrition and inflammation complex.