title: A combination of serum low albumin and above-average cholesterol level was associated with excess mortality.
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% Cl = 0.57-0.96);and the lowest category of serum albumin (< or = 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Health Science, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City, Shiga, 520-2192, Japan. tokamura@belle.shiga-med.ac.jp
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.forename: Takehito
authors.initials: T
authors.lastname: Hayakawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Kadowaki
authors.forename: Yoshikuni
authors.initials: Y
authors.lastname: Kita
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.forename: Paul
authors.initials: P
authors.lastname: Elliott
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood*; D005260:Female; D005783:Gender Identity; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D012709:Serum Albumin / Q000032:analysis*
chemical_list: D015415:Biomarkers; D012709:Serum Albumin; D002784:Cholesterol