Service de Cardiologie, Centre hospitalier Edmond Garcin, Aubagne, France.
Eur J Intern Med. 2018 Jun;52:8-12. doi: 10.1016/j.ejim.2018.04.014. Epub 2018 Apr 19.
Cardiovascular diseases are the leading cause of death worldwide. Endothelial dysfunction, inflammation and oxidative stress are at the forefront in the onset and development of atherosclerosis and many cardiovascular diseases. Epidemiological evidence is that low serum albumin levels are linked to incident ischemic heart disease, heart failure, atrial fibrillation, stroke and venous thromboembolism, independent of risk factors, body mass index and inflammation. Hypoalbuminemia has also emerged as an independent prognosticator in many cardiovascular diseases, such as coronary artery disease, heart failure, congenital heart disease, infective endocarditis and stroke, even after adjusting for usual causal factors and prognostic markers. Given physiological properties of serum albumin that include anti-inflammatory, antioxidant, anticoagulant and antiplatelet aggregation activity as well as colloid osmotic effect, hypoalbuminemia could act as an unrecognized modifiable risk factor. The purpose of this review is to provide an overview of the physiological properties of serum albumin, as well as prevalence, causes, prognostic value and potential contribution to the disease emergence and progression of hypoalbuminemia, and the resulting clinical implications.
心血管疾病是全球范围内的主要死亡原因。内皮功能障碍、炎症和氧化应激是动脉粥样硬化和许多心血管疾病发生和发展的前沿。流行病学证据表明，低血清白蛋白水平与缺血性心脏病、心力衰竭、心房颤动、中风和静脉血栓栓塞的发生有关，独立于危险因素、体重指数和炎症。低白蛋白血症在许多心血管疾病中也已成为一个独立的预后因素，如冠状动脉疾病、心力衰竭、先天性心脏病、感染性心内膜炎和中风，即使在调整了常见的因果因素和预后标志物后也是如此。鉴于血清白蛋白的生理特性，包括抗炎、抗氧化、抗凝和抗血小板聚集作用以及胶体渗透压效应，低白蛋白血症可能是一个未被认识的可改变的危险因素。本综述的目的是概述血清白蛋白的生理特性，以及低白蛋白血症的患病率、原因、预后价值及其对疾病发生和进展的潜在贡献，以及由此产生的临床意义。
