Goldwasser P, Feldman J
Department of Medicine, Brooklyn Veterans Affairs Medical Center, New York 11209, USA.
J Clin Epidemiol. 1997 Jun;50(6):693-703. doi: 10.1016/s0895-4356(97)00015-2.
Reduced levels of serum albumin concentration, a routine blood test, within the "normal" range have been reported to be associated with mortality risk. The literature is reviewed, with a focus on cohort studies meeting specified criteria, and findings are summarized. In studies of many populations, comprising healthy subjects and patients with acute or chronic illness, serum albumin concentration is inversely related to mortality risk in a graded manner over its entire range; the estimated increase in the odds of death ranges from 24% to 56% for each 2.5 g/l decrement in serum albumin concentration. The association predicts overall and cause-specific mortality including cardiovascular mortality. It is likely that albumin concentration is a highly sensitive indicator of preclinical disease and disease severity. A direct protective effect of the albumin molecule is suggested by the persistence of the association after adjustment for other known risk factors and preexisting illness, and after exclusion of early mortality. Although biologically plausible, there is no direct evidence for this hypothesis. Serum albumin concentration is an independent predictor of mortality risk and could be useful in the quantification of risk in a broad range of clinical and research settings.
据报道，常规血液检测中处于“正常”范围内的血清白蛋白浓度降低与死亡风险相关。本文对相关文献进行了综述，重点关注符合特定标准的队列研究，并总结了研究结果。在针对包括健康受试者以及急慢性疾病患者在内的众多人群的研究中，血清白蛋白浓度在其整个范围内均与死亡风险呈分级负相关；血清白蛋白浓度每降低2.5 g/l，估计死亡几率增加24%至56%。这种关联可预测总体死亡率和特定病因死亡率，包括心血管疾病死亡率。白蛋白浓度很可能是临床前疾病和疾病严重程度的高度敏感指标。在对其他已知风险因素和既有疾病进行调整后，以及排除早期死亡情况后，这种关联依然存在，这表明白蛋白分子具有直接的保护作用。尽管从生物学角度来看这一假设合理，但尚无直接证据支持。血清白蛋白浓度是死亡风险的独立预测指标，在广泛的临床和研究环境中对风险量化可能有用。
