Advertisement

Hypoalbuminemia is related to inflammation rather than malnutrition in sarcoidosis

  • Mehdi Mirsaeidi
    Correspondence
    Corresponding author at: Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Miami, Miller School of Medicine, 1600 NW 10th Ave # 7060A, Miami, FL 33136, USA.
    Affiliations
    Division of Pulmonary, Critical Care, Sleep and Allergy, Department of Medicine, University of Miami, FL, USA
    Search for articles by this author
  • Hesham R. Omar
    Affiliations
    Internal Medicine Department, Mercy Medical Center, Clinton, IA, USA
    Search for articles by this author
  • Nadera Sweiss
    Affiliations
    Division of Pulmonary, Critical Care, Sleep and Allergy, Division of Rheumatology, Department of Medicine, University of Illinois at Chicago, USA
    Search for articles by this author
Published:April 24, 2018DOI:https://doi.org/10.1016/j.ejim.2018.04.016
      Albumin is an acute phase reactant that is known to be influenced by many factors including the presence of an underlying inflammatory process. Inflammation was shown to reduce albumin levels irrespective of the patient's nutritional state [
      • Ishida S.
      • Hashimoto I.
      • Seike T.
      • Abe Y.
      • Nakaya Y.
      • Nakanishi H.
      Serum albumin levels correlate with inflammation rather than nutrition supply in burns patients: a retrospective study.
      ], and albumin has thus been considered a negative acute-phase reactant. Among the reasons for reduced albumin levels during acute and chronic inflammatory states is the increased albumin degradation from the high catabolic rate, in addition to its transudation to the extravascular space from increased capillary permeability (e.g. during sepsis) [
      • Lyons O.
      • Whelan B.
      • Bennett K.
      • O'Riordan D.
      • Silke B.
      Serum albumin as an outcome predictor in hospital emergency medical admissions.
      ]. Hypoalbuminemia is associated with increased length of hospital stay and complications [
      • Lyons O.
      • Whelan B.
      • Bennett K.
      • O'Riordan D.
      • Silke B.
      Serum albumin as an outcome predictor in hospital emergency medical admissions.
      ,
      • Marik P.E.
      The treatment of hypoalbuminemia in the critically ill patient.
      ,
      • Haller C.
      Hypoalbuminemia in renal failure. Pathogenesis and therapeutic considerations.
      ]. A large prospective study in patients evaluated at the emergency department showed that the short-term mortality was three times as higher in patients with hypoalbuminemia compared with cases with normal albumin level after adjusting for confounders [
      • Lyons O.
      • Whelan B.
      • Bennett K.
      • O'Riordan D.
      • Silke B.
      Serum albumin as an outcome predictor in hospital emergency medical admissions.
      ].

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ishida S.
        • Hashimoto I.
        • Seike T.
        • Abe Y.
        • Nakaya Y.
        • Nakanishi H.
        Serum albumin levels correlate with inflammation rather than nutrition supply in burns patients: a retrospective study.
        J Med Invest. 2014; 61: 361-368
        • Lyons O.
        • Whelan B.
        • Bennett K.
        • O'Riordan D.
        • Silke B.
        Serum albumin as an outcome predictor in hospital emergency medical admissions.
        Eur J Intern Med. 2010 Feb; 21: 17-20
        • Marik P.E.
        The treatment of hypoalbuminemia in the critically ill patient.
        Heart Lung. 1993; 22: 166-170
        • Haller C.
        Hypoalbuminemia in renal failure. Pathogenesis and therapeutic considerations.
        Kidney Blood Press Res. 2005; 28: 307-310
        • Campillo B.
        • Paillaud E.
        • Uzan I.
        • Merlier I.
        • Abdellaoui M.
        • Perennec J.
        • et al.
        Value of body mass index in the detection of severe malnutrition: influence of the pathology and changes in anthropometric parameters.
        Clin Nutr. 2004 Aug; 23: 551-559
        • Statement on sarcoidosis
        • Joint Statement of the American Thoracic Society (ATS)
        • the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee
        Am J Respir Crit Care Med. February 1999; 160: 736-755
        • Rothkrantz-Kos S.
        • van Dieijen-Visser M.P.
        • Mulder P.G.
        • Drent M.
        Potential usefulness of inflammatory markers to monitor respiratory functional impairment in sarcoidosis.
        Clin Chem. 2003; 49: 1510-1517
        • Sweiss N.J.
        • Barnathan E.S.
        • Lo K.
        • Judson M.A.
        • Baughman R.
        T48 Investigators. C-reactive protein predicts response to infliximab in patients with chronic sarcoidosis.
        Sarcoidosis Vasc Diffuse Lung Dis. 2010 Jul; 27: 49-56
        • Pérez-Guisado J.
        • de Haro-Padilla J.M.
        • Rioja L.F.
        • Derosier L.C.
        • de la Torre J.I.
        Serum albumin levels in burn people are associated to the total body surface burned and the length of hospital stay but not to the initiation of the oral/enteral nutrition.
        Int J Burns Trauma. 2013 Jul 8; 3: 159-163
        • Franch-Arcas G.
        The meaning of hypoalbuminaemia in clinical practice.
        Clin Nutr. 2001 Jun; 20: 265-269
        • Edington J.
        Problems of nutritional assessment in the community.
        Proc Nutr Soc. 1999; 58: 47-51
        • Baker J.P.
        • Detsky A.S.
        • Wesson D.E.
        • et al.
        Nutritional assessment: a comparison of clinical judgement and objective measurements.
        N Engl J Med. 1982; 306: 969-972
      1. http://apps.who.int/classifications/icd10/browse/2016/en#/X. Accessed 11/9/2015.