Kuller L H, Eichner J E, Orchard T J, Grandits G A, McCallum L, Tracy R P
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15261.
Am J Epidemiol. 1991 Dec 1;134(11):1266-77. doi: 10.1093/oxfordjournals.aje.a116030.
The relation between serum albumin levels and subsequent incidence of myocardial infarction and coronary heart disease deaths was evaluated using stored serum from the Multiple Risk Factor Intervention Trial (MRFIT). There were 91 coronary heart disease deaths, 113 myocardial infarction patients, and 405 controls matched to cases within 5 years of age, treatment group, and clinic site. There was a highly significant inverse relation between serum albumin level and risk of coronary heart disease. Individuals with a baseline level of serum albumin greater than or equal to 4.7 g/dl had an odds ratio of 0.45 as compared with individuals with a baseline level of serum albumin less than 4.4 g/dl. The relation persisted after adjusting for other cardiovascular risk factors (blood pressure, smoking, and serum cholesterol). The association was stronger for coronary heart disease deaths than for surviving myocardial infarction patients, and for cigarette smokers as compared with cigarette nonsmokers. The deaths studied occurred in the time period at least 6 years after the sera had been obtained and up to 10.5 years of follow-up, and the myocardial infarctions studied occurred within the first 6.5 years of follow-up. There was no consistent relation between time and death due to coronary heart disease or myocardial infarction and albumin levels. Albumin levels are related to the acute phase reaction. Lower albumin levels may be a marker of persistent injury to arteries and progression of atherosclerosis and thrombosis. The consistent relation between albumin and coronary heart disease risk requires further evaluation.
利用多重危险因素干预试验（MRFIT）中储存的血清，评估了血清白蛋白水平与随后心肌梗死发病率及冠心病死亡之间的关系。共有91例冠心病死亡病例、113例心肌梗死患者以及405例对照，对照组在年龄、治疗组和诊所地点方面与病例匹配，年龄相差在5岁以内。血清白蛋白水平与冠心病风险之间存在高度显著的负相关关系。血清白蛋白基线水平大于或等于4.7 g/dl的个体，与血清白蛋白基线水平低于4.4 g/dl的个体相比，比值比为0.45。在对其他心血管危险因素（血压、吸烟和血清胆固醇）进行调整后，这种关系依然存在。这种关联在冠心病死亡病例中比在存活的心肌梗死患者中更强，在吸烟者中比在不吸烟者中更强。所研究的死亡发生在采血后至少6年且长达10.5年的随访期内，所研究的心肌梗死发生在随访的前6.5年内。冠心病或心肌梗死导致的死亡与白蛋白水平之间不存在一致的时间关系。白蛋白水平与急性期反应有关。较低的白蛋白水平可能是动脉持续损伤以及动脉粥样硬化和血栓形成进展的一个标志。白蛋白与冠心病风险之间的一致关系需要进一步评估。
