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The Prognostic Value of Serum Albumin in Healthy Older Persons with Low and High Serum Interleukin‐6 (IL‐6) Levels
Author(s) -
Reuben David B.,
Ferrucc Luigi,
Wallace Robert,
Tracy Russell P.,
Corti M. Chiara,
Heimovitz Harley,
Harris Tamara B.
Publication year - 2000
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2000.tb02629.x
Subject(s) - medicine , albumin , inflammation , serum albumin , cytokine , gastroenterology , immunology , cohort , endocrinology
OBJECTIVE : We sought to determine the prognostic value of serum albumin for 4‐year mortality among high‐functioning persons who did or did not have evidence of inflammation as indicated by high interleukin‐6 (IL‐6) levels. DESIGN : We used a case‐cohort design of healthy, nondisabled older persons who had serum albumin and plasma IL‐6 measured at baseline. Crude and multiply adjusted (for sociodemographics and chronic diseases) proportional hazards models were used to identify the effect of baseline levels of serum albumin level on 4‐year mortality among those with higher and lower levels of IL‐6. RESULTS : Among subjects without evidence of IL‐6‐mediated inflammation (IL‐6 < 3.20 pg/mL), having a lower (≤4.4 g/dL) albumin level was associated with a multiply adjusted relative risk of 2.1 for 4‐year mortality compared with those with higher albumin. In the presence of inflammation (IL‐6 ≥ 3.20 pg/mL), higher and lower serum albumin levels had similar risks (adjusted relative risks 4.0 and 3.8, respectively) compared with the referent group (higher albumin and low IL‐6). CONCLUSIONS : High serum albumin has a protective effect in healthy older persons who do not have evidence of cytokine‐mediated inflammation. This protective effect is not conferred in presence of inflammation. The mechanisms by which inflammation eliminates the protective effect of high albumin remain to be determined.