Journal of Clinical Epidemiology
Volume 57, Issue 11 , Pages 1188-1195, November 2004

A combination of serum low albumin and above-average cholesterol level was associated with excess mortality

  • Tomonori Okamura

      Affiliations

    • Department of Health Science, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City, Shiga, 520-2192 Japan
    • Corresponding Author InformationCorresponding author. Tel.: +81-77-548-2191; fax: +81-77-543-9732.
  • ,
  • Takehito Hayakawa

      Affiliations

    • Department of Public Health, Shimane University School of Medicine, Izumo, Japan
  • ,
  • Takashi Kadowaki

      Affiliations

    • Department of Health Science, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City, Shiga, 520-2192 Japan
  • ,
  • Yoshikuni Kita

      Affiliations

    • Department of Health Science, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City, Shiga, 520-2192 Japan
  • ,
  • Akira Okayama

      Affiliations

    • Department of Preventive Cardiology, National Cardiovascular Center, Osaka, Japan
  • ,
  • Paul Elliott

      Affiliations

    • Department of Epidemiology and Public Health, Faculty of Medicine, Imperial College London, UK
  • ,
  • Hirotsugu Ueshima

      Affiliations

    • Department of Health Science, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City, Shiga, 520-2192 Japan
  • ,
  • for the NIPPON DATA80 Research Group

      Affiliations

    • Investigators and members of the research group are listed in references 18, 19, and 20.

Accepted 13 February 2004.

Abstract 

Background

There is no population-based prospective study concerning the relation between serum albumin and mortality in a non-Western population, and few previous studies included the subgroup analysis stratified by serum cholesterol level.

Methods

A 13.7-year cohort study was conducted on 6,957 males and females aged 30–59 years from 300 randomly selected areas throughout Japan, who participated in the National Survey on Circulatory Disorders in 1980.

Results

In the group with median and above of total cholesterol, one standard deviation (SD) increment of serum albumin (2.6 g/L for males and 2.4 g/L for females) was inversely associated with all-cause mortality for both males and females (relative risk RR=0.68 and 0.81; 95% confidence interval CI=0.53–0.87 and 0.68–0.98), and with cancer mortality for females (RR=0.74; 95% CI=0.57–0.96); and the lowest category of serum albumin (≤43 g/L) showed the highest cardiovascular mortality for males (RR=5.04; 95% CI=1.04–24.5) among the three albumin categories. These relationships were not evident in the group with total cholesterol level below median.

Conclusion

A combination of a low albumin level and above average cholesterol level, even both within the clinical normal range, is associated with excess mortality in the Japanese general population.

Keywords: Serum albumin, Cholesterol, Mortality, Cohort studies

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PII: S0895-4356(04)00127-1

doi:10.1016/j.jclinepi.2004.02.019

Journal of Clinical Epidemiology
Volume 57, Issue 11 , Pages 1188-1195, November 2004