Li Haowei, Wang Shengshu, Yang Shanshan, Liu Shaohua, Song Yang, Chen Shimin, Li Xuehang, Li Zhiqiang, Li Rongrong, Zhao Yali, Zhu Qiao, Ning Chaoxue, Liu Miao, He Yao
Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, Second Medical Center of Chinese, PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
Department of Healthcare, Agency for Offices Administration, Central Military Commission, People's Republic of China, Beijing, 100082, China.
Diabetol Metab Syndr. 2023 Nov 14;15(1):231. doi: 10.1186/s13098-023-01201-y.
Although hypoalbuminemia was associated with high risk of mortality in community-dwelling older adults, as well as in the hospitalized older adults, little is known among centenarians. And there are limited data on whether having cardiometabolic diseases (CMDs) is associated with additive effects.
Baseline examinations including a determination of albumin levels were performed in 1002 Chinese centenarians from January 2014 through to December 2016, and the survival status was subsequently ascertained until 31 May 2021. Cox proportional risk model was performed to assess the risk of all-cause mortality associated with albumin levels and hypoalbuminemia combined with CMDs.
Of 1002 participants included in the analysis, the mean level of albumin was 38.5 g/L (± standard deviation, 4.0 g/L), and 174 (17.4%) had hypoalbuminemia (albumin < 35 g/L). The multivariable analyses showed that albumin level was negatively associated with all-cause mortality (P < 0.05). Compared to normoalbuminemia, hypoalbuminemia was associated with an increased mortality risk in the overall participants (hazard ratio [HR]: 1.55, 95% confidence interval [CI]: 1.22-1.97). Furthermore, the HR (95% CI) of hypoalbuminemia combined with multiple CMDs was 2.15 (1.14-4.07). There was evidence of an additive deleterious dose effect of an increasing number of CMDs (P = 0.001).
Hypoalbuminemia is associated with an increased risk of all-cause mortality in Chinese centenarians, and this risk is more pronounced among centenarians with multiple cardiometabolic diseases. Our findings suggest that older adults with hypoalbuminemia, especially comorbid multiple CMDs warrant early identification and management.
尽管低白蛋白血症与社区居住的老年人以及住院老年人的高死亡风险相关，但在百岁老人中对此了解甚少。而且，关于患有心脏代谢疾病（CMDs）是否具有累加效应的数据有限。
2014年1月至2016年12月对1002名中国百岁老人进行了包括白蛋白水平测定在内的基线检查，并随后确定其生存状态直至2021年5月31日。采用Cox比例风险模型评估与白蛋白水平以及低白蛋白血症合并CMDs相关的全因死亡风险。
纳入分析的1002名参与者中，白蛋白平均水平为38.5g/L（±标准差，4.0g/L），174人（17.4%）患有低白蛋白血症（白蛋白<35g/L）。多变量分析显示白蛋白水平与全因死亡率呈负相关（P<0.05）。与正常白蛋白血症相比，低白蛋白血症与总体参与者的死亡风险增加相关（风险比[HR]：1.55，95%置信区间[CI]：1.22 - 1.97）。此外，低白蛋白血症合并多种CMDs的HR（95%CI）为2.15（1.14 - 4.07）。有证据表明CMDs数量增加存在累加有害剂量效应（P = 0.001）。
低白蛋白血症与中国百岁老人的全因死亡风险增加相关，且这种风险在患有多种心脏代谢疾病的百岁老人中更为明显。我们的研究结果表明，患有低白蛋白血症的老年人，尤其是合并多种CMDs的老年人需要早期识别和管理。
