title: The prognostic value of serum albumin in healthy older persons with low and high serum interleukin-6 (IL-6) levels.
abstract: 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.
  
  
  METHODS
  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 (< or = 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 > or = 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.
authors.affiliation: Multicampus Program in Geriatric Medicine and Gerontology, UCLA School of Medicine, Los Angeles, California 90095-1687, USA.
authors.forename: D B
authors.initials: DB
authors.lastname: Reuben
authors.forename: L
authors.initials: L
authors.lastname: Ferrucci
authors.forename: R
authors.initials: R
authors.lastname: Wallace
authors.forename: R P
authors.initials: RP
authors.lastname: Tracy
authors.forename: M C
authors.initials: MC
authors.lastname: Corti
authors.forename: H
authors.initials: H
authors.lastname: Heimovitz
authors.forename: T B
authors.initials: TB
authors.lastname: Harris
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003644:Death Certificates; D005260:Female; D005853:Geriatrics; D006304:Health Status; D006801:Humans; D007249:Inflammation / Q000097:blood; D015850:Interleukin-6 / Q000097:blood*; D007484:Iowa; D008297:Male; D009026:Mortality; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012423:Rural Health; D012709:Serum Albumin
chemical_list: D015850:Interleukin-6; D012709:Serum Albumin