Cho, Hye-Min;Kim, Hyeon-Chang;Lee, Ju-Mi;Oh, Sun-Min;Choi, Dong-Phil;Suh, Il
Journal of Preventive Medicine and Public Health
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제45권2호
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pp.98-104
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2012
Objectives: A positive association between serum albumin levels and metabolic syndrome has been reported in observation studies, but it has not been established in the Korean population. The purpose of this study was to evaluate the association between serum albumin levels and the presence of metabolic syndrome among a sample of apparently healthy Korean adults. Methods: This cross-sectional study analyzed data of 3189 community-dwelling people (1189 men and 2000 women) who were aged 40 to 87 years and were living in a rural area in Korea. Serum albumin levels were classified into quartile groups for each sex. Metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III guidelines with an adjusted waist circumference cut-off value ${\geq}90\;cm$ for men and${\geq}85\;cm$ for women). An independent association between serum albumin levels and metabolic syndrome was assessed by multiple logistic regression analysis. Results: Higher serum albumin levels were associated with increased prevalence of metabolic syndrome. The odds ratio (95% confidence interval) of the prevalence of metabolic syndrome for the highest versus the lowest serum albumin quartiles was 2.81 (1.91 to 4.14) in men and 1.96 (1.52 to 2.52) in women, after adjusting for age, smoking status, alcohol consumption, and physical activity. When each metabolic abnormality was analyzed separately, higher serum albumin levels were significantly associated with hypertriglyceridemia and hyperglycemia in both sexes, and with abdominal obesity in men. Conclusions: These results suggest that higher serum albumin levels are positively associated with an increased risk of metabolic syndrome in Korean adults.
BACKGROUND/OBJECTIVES: The level of serum albumin is an index of nourishment care and management. However, the distribution and correlates of serum albumin levels among individuals with motor disorders have not been reported until now. Therefore, we examined the distribution and correlates of serum albumin levels among individuals with motor disorders. SUBJECTS/METHODS: A cross-sectional study on 249 individuals with motor disabilities (144 men, mean age: 51.4 years; 105 women, mean age: 51.4 years) was conducted at five institutions in Ibaraki Prefecture, Japan in 2008. The results were compared with data from the National Health and Nutrition Survey. RESULTS: The mean serum albumin levels were $4.0{\pm}0.4g/dL$ for men and $3.8{\pm}0.5g/dL$ for women. Overall, 17 (11.8%) men and 25 (23.8%) women had hypoalbuminemia (serum albumin level ${\leq}3.5g/dL$); these proportions were greater than those among healthy Japanese adults (${\leq}1%$). Low serum albumin level was related with female sex, older age, low calf circumference, low relative daily energy intake, low hemoglobin (Hb), low blood platelet count, low high-density lipoprotein cholesterol (HDL-C), low $HbA_{1c}$, and high C-reactive protein (CRP) levels. The strongest correlates, based on standardized betas, were Hb (0.321), CRP (-0.279), and HDL-C (0.279) levels. CONCLUSIONS: These results indicate that the prevalence of hypoalbuminemia is higher in individuals with motor disabilities than in healthy individuals and that inflammation is a strong negative correlate of serum albumin levels. Therefore, inflammation should be examined for the assessment of hypoalbuminemia among institutionalized individuals with motor disabilities.
Previous report has suggested that the albumin levels were reduced in the peripheral blood mononuclear cells (PBMCs) and consequently oxidative stress was elevated in streptozotocin (STZ)-induced diabetic rats as albumin is the predominant antioxidant in plasma. In this study, we suggest that the levels of pro-inflammatory cytokine such as interleukin-6 (IL-6) and tumor necrosis factor-${\alpha}$ ($TNF-{\alpha}$) were increased by approximately 3.4- and 2.9-fold, respectively, in the serum of STZ-diabetic rats, compared to those of normal rat. In addition to the cytokines, the levels of C-reactive protein (CRP) were also about 3.6-fold higher, indicating that STZ induced a pro-inflammatory response in rat blood. However, when purified rat albumin was externally co-administrated with STZ through the tail vein, the serum levels of IL-6, $TNF-{\alpha}$, and CRP were markedly reduced, although the values were still higher than those of normal (non-diabetic) rats. Albumin administration also decreased STZ-induced oxidative stress in serum and PBMCs. Moreover, the decrease in cytokine and CRP levels was dependent on the dose of injected albumin. These results suggest that STZ-induced pro-inflammation and oxidative stress in rat blood might be attenuated by treatment with exogenous albumin.
Protein-energy malnutrition, PEM, and increased hs-CRP level are considered to be associated with increased risk of cardiovascular disease (CVD) in hemodialysis (HD) patients. This is commonly referred to as the vicious circle of malnutrition-inflammation-atherosclerosis cardiovascular disease (MIA syndrome) in chronic kidney disease (CKD). Low protein intake can decrease the serum level of albumin and increase inflammational markers; further, both low serum albumin and high hs-CRP are independent risk factors for all-cause mortality in HD patients. The aim of this study is comparing the serum levels of albumin and hs-CRP in HD patients according to the protein intake levels. The total number of subjects was 60 hemodialysis patients; they were grouped by dietary protein intake: low protein intake group (LPI, protein intake < 1.0 g/kg IBW, 11 men and 19 women) and adequate protein intake group (API, protein intake ${\geq}$ 1.0g/kg IBW, 12 men and 18 women). Blood biochemical parameters, nutrient intake, and dietary behaviors were compared between the LPI and API groups. The LPI group showed a significantly lower serum level of albumin and higher serum level of hs-CRP than the API group (p < 0.05). The LPI group showed a significantly lower intake of most nutrients than the API group (p < 0.05). Index of Nutritional Quality of most nutrients of the LPI and API groups were lower than 1.0. Dietary protein intake was positively correlated with the serum level of albumin (r = 0.306, p < 0.05) and negatively correlated with the serum level of hs-CRP (r = -0.435, p < 0.01). The serum level of hs-CRP was negatively correlated with that of albumin (r = -0.393, p < 0.01). According to these result, serum albumin and hs-CRP in HD patients were influenced by the protein intake levels. To prevent MIA syndrome, it is necessary to improve nutritional status, especially in protein and energy.
In order to investigate whether serum Cu, Zn and Cu/Zn ratio are the useful indicater for the diagnosis of cancer. serum Cu and Zn levels were determined from 35 normal subjects and 33 stomach cancer patients by Atomic absorption spectrophotometer. The following results are obtained : Serum copper levels of stomach cancer patients were significantly increased than the those of the normal controls. whereas serum Zn levels significantly decreased than those of the normal contros(P<0.01) Therefore the copper to zinc ratio revealed a significant in the serum Cu and Zn levels. The serum protein and albumin levels were significantly lower in cancer patients(P<0.01) And the correlation analysis indicated that there was no significant correlation between serum Cu/Zn ratio and protein or albumin. These data suggest that the serum Cu. Zn and Cu/Zn ratio may be used as a diagnostic test in stomach cancer patients.
Background: Hypoalbuminemia (serum albumin < 3.5 g/dL) is associated with increased morbidity and mortality in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, costs associated with hypoalbuminemia remain unknown. This study investigated the effect of serum albumin on direct treatment costs, length of stay (LOS), and readmissions for primary and revision THA and TKA patients. Methods: All adult patients at a single institution undergoing primary or revision THA or TKA between January 2014 and December 2016 were retrospectively reviewed. Patients were stratified by preoperative serum albumin level. The primary outcome was total direct costs at index hospitalization. Secondary outcomes included LOS and readmission within 30 days. Multivariable regressions were utilized to adjust for demographics and comorbidities. Results: Of 3,785 patients, 114 (3.0%) had hypoalbuminemia. After adjustment, hypoalbuminemia was associated with a 16.2% increase in costs (${\beta}=0.162$; 95% confidence interval [CI], 0.112 to 0.213; p < 0.001), representing an average cost increase of $3,383 (95% CI, $2,281 to $4,485) relative to costs for serum albumin > 4.5 g/dL. The increased total costs were significantly higher in revision ($4,322, p = 0.034) than in primary ($3,446, p < 0.001) procedures. In adjusted regression, each 1.0 g/dL increase in serum albumin yielded a 6.6% reduction in costs (${\beta}=-0.066$; 95% CI, -0.090 to -0.042]; p < 0.001), for average savings of $1,282 (95% CI, $759 to $1,806) per unit albumin. Adjusted regressions demonstrated that a 1-point increase in serum albumin reduced readmissions by 53% (odds ratio, 0.47; 95% CI, 0.31-0.73; p = 0.001) and LOS by 0.6 days (${\beta}=-0.60$; 95% CI, -0.76 to -0.44; p < 0.001). Conclusions: Hypoalbuminemia is associated with increased total direct costs, LOS, and readmissions following primary and revision THA and TKA. Future efforts to predict and address total costs should take into consideration the patient's preoperative serum albumin levels.
Selenium is a strong antioxidant trace mineral, scavenging free radicals. The prevalence of chronic degenerative diseases is increasing in Korean adults with increasing age. The increased cell damage from free radicals has been implicated in the etiology of these diseases, and evidence is accumulating that the low selenium status that comes with advanced aged is involved in the prevalence of age-associated diseases. However, little is known about the selenium status of Koreans, its age-related change and its relationship to dietary nutrient intake. In this study, the serum selenium levels of healthy adult females according to life cycle and its association with blood albumin levels and nutrient intake were examined. Serum selenium level was measured with the Huwo research reactor using the neutron activation analysis method (NAA). The overall proportion of women with selenium deficiency, serum selenium concentrations below 7.0 $\mu\textrm{g}$/dl, was 9.4%. The average serum selenium levels were 12.39 $\mu\textrm{g}$/dl, 9.45 $\mu\textrm{g}$/dl and 9.16 $\mu\textrm{g}$/dl in the young adult, middle-aged and elderly groups, respectively, showing a reduction of selenium status with advancing age. Selenium deficiency was seen only in the elderly group. Generally, serum selenium levels positively or negatively correlated with nutrient intake, but these association patterns differed depending on the age. The nutrients that showed positive correlations with selenium levels were proteins and phosphate in the young adult group (p < 0.05, p < 0.05), and total calcium, potassium and vegetable-origin calcium in the middle-aged group. Vitamin C and fiber were the negative correlated nutrients with serum selenium levels in the elderly group (p < 0.05, p < 0.05). Multiple stepwise regression analysis of the determining factors responsible for selenium status showed that age and serum albumin levels were important factors which explained up to 26.9% variances in serum selenium levels. The average selenium concentrations of Korean adult female subjects were above the deficiency levels in all three age groups. There was a tendency toward decreasing selenium levels as the age of the subjects increased. The factors with the strongest in-fluence on selenium status in healthy adult Korean females were age and serum protein status. (Korean J Nutrition 36(5): 491~499, 2003)
This study investigated the nutritional status of 33 hemodialysis patients. Their weight, height, triceps and mid-arm circumference were measured and their dietary intake and blood profiles evaluated. The subjects were 57.1$\pm$11.9 years old. The energy intakes of men and women were 61% and 68% of RDA, respectively. The men and women's intake of protein was 0.93g/IBWkg/d and 0.99g/IBWkg/d, respectively. According to the distribution of BMI, 22.2% of the men and 73.3% of the women were underweight. A total of 5.6% of the men were overweight, versus none of the women. The serum albumin levels of the men and women were 3.56 and 3.52g/dl, respectively. The serum cholesterol levels of the men and women were 134.1 and 148.5mg/dl, respectively. The subjects were divided into three groups according to the level of albumin, and their intakes of nutrients were compared with one another. The group with high levels of albumin did not show higher energy and protein intake than the other groups but the serum total protein level was significantly higher. When the nutritional status of the patients was evaluated by weight and serum albumin level, 6.0% of them showed kwashiorkor-type malnutrition and 75.8% of them showed mild malnutrition.
Objective: Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome in adults. However, there is not a satisfactory treatment for MN. This study aimed to evaluate the effect of Houttuyniae Herba Extract (HHE) on MN induced by cationic bovine serum albumin (cBSA). Methods: Mice were divided into 4 groups. The first group, Normal, was injected with saline. The second group, Control, was treated with cBSA (10mg/kg i.p) only. The third group, HHE-250, was treated with cBSA (10mg/kg i.p) and HHE (250mg/kg, p.o). The fourth group, HHE-500, was treated with cBSA (10mg/kg i.p) and HHE (500mg/kg, p.o). After treatment for 4 weeks, we measured change of body weight, 24 hrs proteinuria, serum albumin, total cholesterol, triglyceride, BUN, creatinine, IgA, IgM, IgG, TNF-${\alpha}$, IL-1${\beta}$ levels and the mRNA expression of IFN-${\gamma}$, IL-6, and IL-10. The morphologic changes of renal glomeruli were also observed with a light microscope and an electron microscope. Results: The levels of 24 hrs proteinuria and serum triglyceride, BUN, IgG, TNF-${\alpha}$, IL-1${\beta}$ significantly decreased in both HHE groups, while the level of serum albumin significantly increased in both HHE groups. The mRNA expression of IFN-${\gamma}$ and IL-6 in splenocytes considerably increased in both HHE groups. The mRNA expression of IL-10 in splenocytes considerably decreased in both HHE groups. In histological findings of kidney tissue, thickening of GBM decreased in both HHE groups. Conclusions: This study shows that HHE might be effective for treatment of acute stage MN. More clinical data and studies are to be done for efficient application.
Background: Impaired oxidative/antioxidative status plays an important role in the pathogenesis of many diseases like cancer. The aim of this study was to evaluate the levels of the novel marker ischemia modified albumin (IMA) and albumin adjusted-IMA (Adj-IMA) in patients with bladder cancer (BC) as well as its association with total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI). Materials and Methods: Forty male patients with BC (mean age, $67.4{\pm}12$ years) and forty age-sex matched healthy persons (mean age $56.0{\pm}1.7$ years) were included in this study. Serum levels of IMA, TAS, TOS were analyzed and Adj- IMA and OSI was calculated. Results: Serum IMA, TOS and OSI values were significantly higher in patients with BC compared to controls (p<0.0001, p=0.01 and p=0.01, respectively), whereas TAS was significantly lower in BC patients (p=0.04). There was no significant difference for serum albumin-adjusted IMA levels between groups (p=0.4). Conclusions: In this study, it was found that there was an impaired oxidative/antioxidant status in favor of oxidative stress in BC patients. This observation was not confirmed by Adj-IMA calculation. There is no published report about serum concentrations of IMA in patients with BC. Further studies are needed to establish the relationship of IMA and oxidative stress parameters in BC and the significance of IMA to other cancers.
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