Maternal Serum Albumin Redox State Is Associated with Infant Birth Weight in Japanese Pregnant Women

Background: Plasma albumin (ALB) reflects protein nutritional status in rats, but it is not clear whether it is associated with dietary protein insufficiency in pregnant women and/or their risk of low birth weight delivery. This study aimed to investigate whether maternal serum ALB redox state reflects maternal protein nutritional status and/or is associated with infant birth weights. Methods: The relationship between the serum reduced ALB ratio and infant birth weight was examined in an observational study of 229 Japanese pregnant women. A rat model simulating fetal growth restriction, induced by protein-energy restriction, was used to elucidate the relationship between maternal nutritional status, maternal serum ALB redox state, and birth weight of the offspring. Results: In the human study, serum reduced ALB ratio in the third trimester was significantly and positively correlated with infant birth weight. In the rat study, serum reduced ALB ratio and birth weight in the litter decreased as the degree of protein-energy restriction intensified, and a significant and positive correlation was observed between them in late pregnancy. Conclusions: Maternal serum reduced ALB ratio in the third trimester is positively associated with infant birth weight in Japanese pregnant women, which would be mediated by maternal protein nutritional status.     

The role of albumin in human physiology and pathophysiology, Part III: Albumin and disease states

The serum albumin level is one of several clinical parameters of the status of general health. There is a marked correlation between low albumin levels and the incidence of morbidity and mortality in hospitalized patients. Therefore, it is not surprising to find that hypoalbuminemia is a common finding among hospitalized patients. This results from alterations in the catabolic or anabolic rates, losses of albumin, or redistribution between the various fluid compartments of the body. Somewhat less well defined than the role of albumin as a prognostic indicator is its role in compounding pathophysiology. Hypoalbuminemia is known to be associated with delayed wound healing. The hypoalbuminemic state interferes with the normal functioning of the gastrointestinal tract. Qualitative changes in the albumin molecule which occur in renal disease may damage the nephron. Low serum albumin levels may adversely affect the coagulation system. Further investigation into the role of albumin in pathophysiology is warranted.     

Enteral Nutrition in Dementia: A Systematic Review

The aim of this systematic review is to evaluate the role of enteral nutrition in dementia. The prevalence of dementia is predicted to rise worldwide partly due to an aging population. People with dementia may experience both cognitive and physical complications that impact on their nutritional intake. Malnutrition and weight loss in dementia correlates with cognitive decline and the progress of the disease. An intervention for long term eating difficulties is the provision of enteral nutrition through a Percutaneous Endoscopic Gastrostomy tube to improve both nutritional parameters and quality of life. Enteral nutrition in dementia has traditionally been discouraged, although further understanding of physical, nutritional and quality of life outcomes are required. The following electronic databases were searched: EBSCO Host, MEDLINE, PubMed, Cochrane Database of Systematic Reviews and Google Scholar for publications from 1st January 2008 and up to and including 1st January 2014. Inclusion criteria included the following outcomes: mortality, aspiration pneumonia, pressure sores, nutritional parameters and quality of life. Each study included separate analysis for patients with a diagnosis of dementia and/or neurological disease. Retrospective and prospective observational studies were included. No differences in mortality were found for patients with dementia, without dementia or other neurological disorders. Risk factors for poor survival included decreased or decreasing serum albumin levels, increasing age or over 80 years and male gender. Evidence regarding pneumonia was limited, although did not impact on mortality. No studies explored pressure sores or quality of life.     

The paradox of normal serum albumin in anorexia nervosa: a case report

OBJECTIVE: Anorexia nervosa (AN) is associated with marked decreases in caloric intake and a corresponding reduction in body weight due to abnormal self body image. Although counterintuitive, hypoalbuminemia and vitamin deficiencies are not expected consequences of this disorder. Etiologic considerations for hypoalbuminemia are discussed. METHOD: The case report of a patient with AN and marked hypoalbuminemia is presented and a focused literature review is reported. RESULTS: Hypoalbuminemia was initially attributed to starvation. However, occult infection was ultimately responsible. Serum albumin concentration normalized with antibiotic therapy despite minimal restoration of body weight. DISCUSSION: Hypoalbuminemia should not be considered a characteristic feature of AN even in the setting of progressive weight loss. The presence of other potentially life-threatening conditions should be sought, as reduced serum albumin concentration is a marker of inflammation in AN.     

Serum albumin in older persons: relationship with age and health status.

We analyzed data from 4115 persons aged 71 years and older who had blood drawn at a home visit in three communities to examine the cross-sectional distribution of serum albumin and correlates of hypoalbuminemia. Mean albumin was lower among older persons, from 41.6 g/l in men aged 71-74 years to 38.5 g/l in men 90 years or older, and from 41.1 g/l to 38.9 g/l in women of the same ages, respectively. Hypoalbuminemia (albumin less than 35 g/l) was observed in 3.1% of subjects. Hypoalbuminemia and lower serum albumin were independently associated with anemia, recent diagnosis of cancer, two or more limitations in activities of daily living, residence in a nursing home, heavy cigarette smoking (greater than 1 pack/day), and older age. A 10-year age increment was associated with 0.8 g/l lower serum albumin and odds ratio of 1.56 (95% CI 1.14, 2.13) for hypoalbuminemia after adjusting for demographic factors and health status. Characteristics associated with serum albumin may confound the reported relationship between serum albumin and mortality.     

The redox state of recombinant human serum albumin and its optimal concentration for mouse embryo culture

Albumin has multiple physiological functions in embryo culture, such as a chelator of heavy metals, free radical scavenger, pH and osmotic regulator, a stabilizer, growth factor carrier, a surfactant, and a nutrient. However, the commercially available human serum albumin (HSA) products may not be completely safe since they could be contaminated with viruses and prions. Recombinant human serum albumin (rHSA) has been reported to be as efficient as commercial HSA for fertilization and embryo development. Despite the possible benefits of rHSA, it has not been widely used for embryo culture due to its high cost of production. Our objective was to analyze the redox state of different types of HSA products and rHSA to define oxidative status batch variations of HSA and rHSA and to evaluate the optimal concentration of rHSA for mouse embryo culture. The redox state of the HSA and rHSA used in embryo culture media was found to vary widely. Redox variations were found among different HSA batches as well as among rHSA batches. The highest blastocyst development and hatching rates were obtained with rHSA used at a concentration of 0.05?mg/mL. We showed that very low concentrations of rHSA were most favorable for advanced mouse embryo development in culture.     

海南百岁老人血清白蛋白水平与健康相关生活质量的关联性研究

目的探讨中国海南百岁老人血清白蛋白水平与健康相关生活质量的关系。方法本研究数据来自中国海南百岁老人队列研究2014-2016年横断面数据集,共纳入1002名百岁老人进行问卷调查、体格检查和生物学标本检测。采用EQ-5D-VAS量表测量健康相关生活质量,采用多重线性回归和多元logistic回归分析血清白蛋白和健康相关生活质量的关联。结果血清白蛋白与视觉模拟量表得分之间存在正向线性关系,在完全调整模型中标准化β值为0.156(P<0.001)。在多元logistic回归分析中,低白蛋白水平组的健康相关生活质量受损的风险是高白蛋白水平组的2.369倍(95%CI:1.424~3.939);性别分层分析显示,男性百岁老人中OR=4.406(95%CI:1.537~12.631),女性百岁老人中OR=2.035(95%CI:1.125~3.680)。结论海南百岁老人中较低水平的血清白蛋白水平与健康相关生活质量下降有关。     

白蛋白辅助治疗小儿难治性腹泻疗效观察

目的:观察人血白蛋白辅助治疗小儿难治性腹泻临床疗效。方法:60例符合小儿难治性腹泻诊断标准的患儿随机分为治疗组(32例)和对照组(28例),在积极常规治疗小儿难治腹泻的基础上,治疗组施用人血白蛋白0.5～1.0 g.kg-1.d-1静脉滴注,连用2～3天。结果:治疗组总有效率90.6%,对照组总有效率75.0%,两组比较差异无统计学意义(P>0.05)。治疗组平均治疗时间(5.9±2.7)天,对照组平均治疗时间(9.6±3.1)天,两组比较差异有统计学意义(P<0.01)。治疗组低蛋白血症纠正率100.0%,对照组纠正率53.3%,两组比较差异有统计学意义。结论:小儿难治性腹泻病在常规治疗的基础上施用人血白蛋白为机体提供营养,可缩短治疗时间,加快病情康复。     

Albumin synthesis rates are not responsive to hyperglycemic hyperinsulinemia in postoperative patients

Background: Insulin regulates albumin synthesis in vitro and in various experimental models. The current study was undertaken to determine the effects of a physiologic hyperinsulinemia on albumin synthesis in postoperative patients in whom plasma albumin concentrations are decreased. Methods: Studies were performed in postabsorptive patients after major abdominal operations. Mass spectrometry techniques were used to directly determine the incorporation rate of 1‐[¹³C]‐leucine into albumin. Consecutive blood samples were taken during a continuous isotope (D‐Glc) infusion (0.16 µmol/kg/min). Isotopic enrichments were determined at baseline (period I) and after a 4‐hour D‐glucose (D‐Glc) infusion at currently recommended rates (170 mg/kg/h, n = 10) or after infusion of saline (control group, n = 8) (period II). Results: After D‐Glc infusion, plasma insulin concentrations increased significantly (period I, 6.6 ± 1.8 µU/mL; period II, 21.4 ± 2.1 µU/mL; P < .01). In contrast, plasma insulin concentration remained constant in control patients (period I, 3.8 ± 0.9 µU/mL^?1; period II, 5.9 ± 1.1 µU/mL; not significant vs period I, but P < .005 vs the corresponding value at the end of period II in the control group). Hyperinsulinemia was without effect on fractional albumin synthesis (period I, 12.8% ± 1.9%/d; period II, 11.9% ± 1.9%/d; not significant), and synthesis rates corresponded to those measured in controls (period I, 13.0% ± 1.2%/d; period II, 12.1% ± 0.1%/d; not significant vs period I and vs D‐Glc infusion). Conclusions: A standard D‐Glc infusion is insufficient to increase albumin synthesis in postoperative patients.     

Colitis increases albumin synthesis at the expense of muscle protein synthesis in macronutrient-restricted piglets

Our aim was to examine the effect of acute inflammation localized in the colon and early macronutrient restriction on protein synthesis in a piglet model. In a 2 x 2 factorial design, piglets (n = 32) were fed an adequate or macronutrient-restricted diet with or without dextran sulfate-induced colitis for 7 d. The stable isotope tracer L-[5,5,5-(2)H(3)]leucine was infused to determine protein kinetics at the whole-body level and synthesis of tissue and plasma proteins. In the well-nourished state, colitis did not affect weight gain or protein kinetics except for an increase in albumin synthesis (P < 0.05). Macronutrient restriction alone caused a general slowing of protein metabolism including decreased weight gain (P < 0.0004), whole-body protein turnover (P < 0.0001), and liver (P < 0.01) and plasma protein (P < 0.03) synthesis. However, in the presence of macronutrient restriction, colitis compromised weight gain further (P < 0.02) and decreased muscle protein synthesis (P < 0.05) due to a redistribution of protein metabolism that supported enhanced synthesis of plasma proteins. The increased contribution of plasma protein synthesis to whole-body protein turnover was attributable mainly to increased synthesis of albumin (P < 0.006). Concentrations of plasma proteins were unaffected despite dramatic changes in their synthesis rates, thereby underestimating the effects of malnutrition and colitis on protein metabolism. Increased synthesis of plasma proteins, particularly the negative acute phase reactant albumin, compromises weight gain and muscle protein synthesis only when macronutrient intake is inadequate, underscoring the role of adequate nutrition in preventing growth impairment and muscle wasting in acute inflammation. These results suggest that the hypoalbuminemia of inflammatory bowel disease should not be attributed to decreased synthesis.     

Influence of insulin on albumin and non-albumin protein fractional synthetic rates in post-absorptive type I diabetic patients

Two 8-h primed continuous infusions of L-[1-13C] leucine were used to determine fractional synthesis rates of albumin and non-albumin plasma protein in post-absorptive Type I diabetic patients during insulin infusion and its withdrawal. Fractional protein synthetic rates were calculated from the rate of incorporation of 13C-label into protein and employing plasma 13C-alpha-ketoisocaproic acid enrichment to represent the precursor pools label. Incorporation of 13C into albumin and non-albumin plasma protein was linear over the latter 6 h of the 8-h L-[1-13C] leucine infusion. Fractional synthetic rates of plasma albumin and non-albumin proteins were similar during insulin withdrawal and its infusion. The increased whole-body protein synthesis observed during insulin withdrawal in Type I diabetic patients appears unrelated to events in albumin and non-albumin plasma protein fractions. These data are further evidence that insulin per se does not stimulate protein synthesis in man.     

Bone Mineral Density,Serum Albumin and Serum Magnesium

Objectives: This study explores clinical and laboratory abnormalities that contribute to the prevalence of bone fractures in frail and control elderly patients, to ascertain factors that relate to bone strength and fragility.

Methods: Patients were selected as free from renal failure and not taking supplements or medications that affect their magnesium status, and categorized according to their underlying diseases, sex and age, and evaluated by tests of bone strength.

Results: Findings, differentiating elderly patients on the basis of their magnesium, calcium, serum albumin, body mass, bone mineral density and their fracture occurrence were tabulated.

Conclusion: Evidence is presented of low magnesium and albumin serum levels, especially in women with low bone density, as well as of low calcium and trace minerals.     

肺结核发热症状的控制与机体血清白蛋白水平相关分析

目的　分析伴有发热症状的肺结核病人抗结核治疗后发热症状控制情况与血清白蛋白水平之间的关系。方法　抽取 2 0 0 0年至 2 0 0 2年在本院的初治菌阳伴有发热症状的肺结核患者 114例 ,测定其血清白蛋白 ,根据其数值将患者分为白蛋白正常组、白蛋白低下组 ,观察其接受抗结核治疗后发热症状被控制的情况并进行对比分析。结果　白蛋白正常的病人接受抗结核治疗后发热症状较易被控制 ,白蛋白低下治疗后发热症状较难被控制 ,两组间差异有显著性 (P <0 .0 0 5 )。结论　机体血清白蛋白水平低下会影响肺结核发热症状的控制。     

Effect of zinc supplementation on protein metabolism in late-middle-aged men: The Zenith study

OBJECTIVE: Zinc (Zn) is an essential trace element that is a potent enhancer of protein metabolism due to its numerous roles in metabolic processes. Protein turnover decreases with age. We determined whether a Zn supplementation, which increases serum Zn concentration and Zn exchangeable pool mass, modifies whole-body protein turnover and albumin and fibrinogen synthesis rates in late-middle-aged men. METHODS: Three groups of 16 healthy subjects 55-70 y of age participated in a randomized, doubled-blinded, placebo-controlled intervention. Each group received 0, 15, or 30 mg/d of supplemental Zn for 6 mo. At the end of the supplementation period, each subject received an intravenous infusion of L-[1-13C] leucine to quantify whole-body leucine fluxes and synthesis rates of albumin and fibrinogen. RESULTS: In the placebo group, mean +/- SEM whole-body leucine fluxes to protein synthesis, to oxidation, and from protein degradation were 1.46 +/- 0.05, 0.40 +/- 0.01, and 1.73 +/- 0.06 micromol.kg(-1).min(-1), respectively. Zn supplementation did not significantly change whole-body leucine fluxes. In the placebo group, plasma concentration and fractional rate of protein synthesis were 45 +/- 1 g/L and 8.2 +/- 0.6%/d for albumin and 3.6 +/- 0.2 g/L and 16.7 +/- 1.3%/d for fibrinogen, respectively. Zn supplementation did not significantly change these parameters or the absolute rates of synthesis of these proteins. CONCLUSION: Increasing Zn supply does not modify whole-body protein metabolism and synthesis rates of albumin and fibrinogen in late-middle-aged men.     

The role of albumin in nutritional support.

Hypoalbuminemia is considered one of the hallmarks of protein-calorie malnutrition and chronic liver disease. Recently, serum albumin has also been proposed as a critical predictor of the response to nutritional support and tolerance to enteral feeding in critically ill patients. Albumin is essential for maintenance of plasma colloidal osmotic pressure, prevention of edema, and transport of certain drugs and nutrients. Experimental studies have shown that rapid plasma expansion and reduced plasma protein concentration and osmotic pressure induce a net secretion of sodium and water into the small intestinal lumen. However, the effects of chronic hypoalbuminemia per se on intestinal absorption, independent of malnutrition, have not been fully studied. It is documented that both chronic illness and malnutrition may profoundly affect intestinal anatomical structure and function, inducing some degree of malabsorption. In the last few years, some have advocated albumin infusion to improve clinical response to patients with hypoalbuminemia receiving parenteral nutritional support or to reduce intestinal intolerance and diarrhea in patients receiving enteral tube feeding. A review of the literature shows that both clinical and experimental data to support these suggestions are scarce and further investigations are needed. Hypoalbuminemia is one of many parameters of malnutrition, and it is unlikely that correction of a single parameter for a short time would lead to major clinical benefits.     

Dietary protein intake affects albumin fractional synthesis rate in younger and older adults equally

Inclusion of dietary protein in meals and beverages affects the hepatic synthesis of the protein albumin. Besides dietary protein, several factors can influence albumin metabolism and affect plasma albumin. The role of aging in albumin synthesis is unclear. Recent research documents that albumin synthesis rate is influenced comparably in younger and older adults by dietary protein ingestion and changes in dietary protein quantity. This emphasizes the importance for all adults to consume an adequate amount of dietary protein.     

Malnutrition in hospitalized elderly patients: when does it matter?

BACKGROUND: Identifying the individual effects of acute illness and malnutrition on elderly patient outcome and the timing of nutritional support is still an important challenge for modern medicine. OBJECTIVE: The aims of this study were to assess the practical significance of serum albumin concentrations following acute illness as a measure of nutritional status in ageing patients and also to review recently published studies related to this field. DESIGN: Consecutive stroke patients had their nutritional status assessed from anthropometric, haematological and biochemical data during the hospital stay. Predicted energy needs and daily in-hospital energy intake were also studied in a subgroup of 24 acute stroke patients and 24 age and sex-matched hospitalized non-stroke patients. A multivariate analysis was used to measure the amount of variance in serum albumin concentrations explained by nutritional and non-nutritional clinical variables. RESULTS: Serum albumin concentrations deteriorated steadily during the study period and there was an increase in the amount of variance in the serum albumin explained by nutritional variables between admission and week 4 of the hospital stay. Almost all patients studied were in negative energy balance during hospitalization. Evidence is provided which links low serum albumin concentrations with clinical outcomes during the hospital stay and immediately following discharge. That nutritional supplementation started one week as opposed to immediately following acute illness, and continued during the convalescent period, can improve serum albumin concentrations during the hospital stay. CONCLUSION: Poor nutritional status following acute illness in ageing patients may be of more prognostic significance and amenable to therapy later on during the course of hospitalization.     

Hypoalbuminemia in acute ischemic stroke patients: frequency and correlates

OBJECTIVE: Hypoalbuminemia in acute stroke patients is associated with increased mortality and morbidity. The aim of our study was to determine the frequency and correlates of hypoalbuminemia in unselected cohort of patients with acute cerebral infarction. DESIGN: Prospective study. SETTING: University hospital. SUBJECTS: Seven hundred and five consecutive ischemic stroke patients. METHODS: Albumin and other serum protein fractions were measured within 36 h after stroke using electrophoresis. RESULTS: Hypoalbuminemia defined as serum albumin level <35 g/l was found in 45.5% of patients. Serum albumin level correlates significantly with age (r=-0.13, P<0.01), Scandinavian Stroke Scale score (r=0.14, P<0.01), body temperature on admission (r=0.14, P<0.01), leukocyte count (r=-0.17, P<0.01), fasting glucose (r=-0.16, P<0.01), total cholesterol (r=0.14, P<0.01), alpha1-globulin (r=-0.48, P<0.01), alpha2-globulin (r=-0.49, P<0.01), beta-globulin (r=-0.26, P<0.01) and gamma-globulin (r=-0.35, P<0.01). CONCLUSIONS: Hypoalbuminemia is a frequent finding in acute stroke patients and it is associated with more severe stroke and pro-inflammatory pattern of serum protein electrophoresis.     

白果清蛋白抑制肿瘤活性及其机制的初步研究

目的:研究白果清蛋白(Ginkgoalbumin,GA)对S180肿瘤的抑制活性,并探讨其抗肿瘤作用机制。方法:采用质谱法测定了白果清蛋白GAⅡa的分子量;采用D-脱氧核糖法和硝基蓝四唑(NBT)光化还原法研究了GA抗氧化活性;观察GA的体内抗S180肿瘤作用,用甲基噻唑四唑MTT法测定GA体外对S180细胞的抑制生长作用。结果:GA的分子量为29248u;能抑制体内S180实体瘤和体外S180肿瘤细胞的生长,具有较强的体外清除OH及O2的能力。结论:抑制S180肿瘤生长的作用可能与其抗氧化活性有关。     

Fat-soluble-vitamin status during the first year of life in infants with cystic fibrosis identified by screening of newborns

We investigated the fat-soluble-vitamin status during the first year of life in 36 infants with cystic fibrosis (CF) consecutively identified by screening of newborns. At initial evaluation (at age 51.0 +/- 26.7 d) 36% of patients were hypoalbuminemic, 21% had low serum retinol, 35% had low serum 25-hydroxyvitamin D. 38% had low serum alpha-tocopherol and low ratios of serum vitamin E to total lipids, and none had elevated protein in vitamin K absence (PIVKA). Hypoalbuminemia was more common in breast-fed than in formula-fed infants. Seventy-two-hour fecal fat excretion correlated inversely with serum alpha-tocopherol. Treatment with oral pancreatic enzyme supplements, a multiple vitamin, and additional vitamin E was associated with normalization of serum albumin, retinol, and 25-hydroxyvitamin D and negative PIVKA at age 6 and 12 mo. Approximately 10% of patients remained vitamin E deficient. Biochemical evidence of fat-soluble-vitamin deficiencies is common before age 3 mo in patients with CF and, except for vitamin E, these deficiencies corrected with standard therapy.