Journal
ANNALS OF MEDICINE
Volume 50, Issue 3, Pages 240-248Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1080/07853890.2018.1441537
Keywords
Serum albumin; venous thromboembolism; inflammation; cohort study
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Funding
- Finnish Foundation for Cardiovascular Research, Helsinki, Finland
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care - East Midlands (NIHR CLAHRC - EM)
- Leicester Clinical Trials Unit
- NIHR Leicester-Loughborough Diet, Lifestyle and Physical Activity Biomedical Research Unit
- University Hospitals of Leicester NHS Trust, Loughborough University
- University of Leicester
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Purpose: We aimed to assess the prospective association of serum albumin with venous thromboembolism (VTE) risk and evaluate if the association is independent of or modified by inflammation, as measured by high sensitivity C-reactive protein (hsCRP). Design: We analysed data of 2176 men aged 42-61 years free from VTE in the Kuopio Ischemic Heart Disease study, with serum albumin concentrations measured at baseline using Coulter's bromocresol purple colorimetric assays. Hazard ratios (HRs) (95% confidence intervals [CI]) were calculated for VTE. Results: There were 109 validated cases of VTE recorded during a median follow-up of 24.9 years. The risk of VTE increased linearly below a serum albumin concentration of similar to 48g/l. In Cox regression analysis adjusted for established risk factors and other potential confounders, the HR (95% CI) for VTE per 1 standard deviation lower serum albumin was 1.23 (1.02-1.47). The association remained persistent on further adjustment for hsCRP 1.22 (1.01-1.46). Furthermore, the association was not modified by hsCRP and persisted on exclusion of men with elevated hsCRP levels. Conclusions: In middle-aged Caucasian men, low serum albumin is associated with an increased risk of VTE, consistent with a linear dose-response relationship. The association is independent of and not modified by inflammation.
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