Lower serum albumin concentration and change in muscle mass: the Health, Aging and Body Composition Study.
BACKGROUND
Low albumin concentrations in older persons increase the risk of poor health outcomes, including functional decline.


OBJECTIVE
The aim of the study was to investigate the association between serum albumin concentration and skeletal muscle loss (sarcopenia) in old age.


METHODS
Serum albumin concentration was measured in 1882 black and white men and women aged 70-79 y participating in the Health, Aging and Body Composition Study. Five-year changes in appendicular skeletal muscle mass (ASMM), total-body fat-free mass (FFM), and trunk lean mass (TLM) were measured by using dual-energy X-ray absorptiometry. Confounders included health and lifestyle factors, which are markers of inflammation and protein intake.


RESULTS
A low albumin concentration (< 38 g/L) was observed in 21.2% of the study participants. After adjustment for confounders, the mean (+/-SE) change in ASMM was -82 +/- 26 g per 3-g/L lower albumin concentration (P = 0.002). This association remained after persons with a low albumin concentration (< 38 g/L) were excluded. The decline in ASMM in subjects with low albumin concentrations was almost 30% higher (-930 +/- 56 g) than that in those with albumin concentrations > or = 42 g/L (-718 +/- 38 g; P < 0.01). The association between albumin and change in ASMM remained after additional adjustment for weight change. A weak association was observed for FFM, whereas no association was observed for TLM, which suggests a specific role of albumin in skeletal muscle change.


CONCLUSIONS
Lower albumin concentrations, even above the clinical cutoff of 38 g/L, are associated with future loss of ASMM in older persons. Low albumin concentration may be a risk factor for sarcopenia.
Visser
Marjolein
M
Institute of Health Sciences, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, The Netherlands. marjolein.visser@falw.vu.nl
Kritchevsky
Stephen B
SB
Newman
Anne B
AB
Goodpaster
Bret H
BH
Tylavsky
Frances A
FA
Nevitt
Michael C
MC
Harris
Tamara B
TB
D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000378:metabolism*; D000368:Aged; D000375:Aging / Q000097:blood / Q000502:physiology*; D001823:Body Composition / Q000502:physiology*; D004044:Dietary Proteins / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D018482:Muscle, Skeletal / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000378:metabolism*; D009133:Muscular Atrophy / Q000097:blood*; D011446:Prospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*
D004044:Dietary Proteins; D012709:Serum Albumin