Serum albumin and mortality risk in a hyperendemic area of HCV infection in Japan.
Serum albumin and mortality risk in a hyperendemic area of HCV infection in Japan.
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DOI：
10.1186/1743-422x-7-375
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发表时间：
2010-12-31
期刊：
影响因子：
4.8
通讯作者：
Sata M
中科院分区：
文献类型：
--
作者：
Nagao Y;Sata M
低白蛋白血症已被证明与死亡率增加有关。我们报道了 1990 年日本 X 镇的一次大规模筛查，结果显示丙型肝炎病毒 (HCV) 感染率很高。这项追踪研究通过12年的时间来确定血清白蛋白水平是否对X镇居民的生活预后产生影响。到 2002 年，509 名受试者中，69 人死亡，55 人移居其他地区。因此，我们分析了 1990 年至 2002 年间可确认生死的 454 人。白蛋白水平被分为两组，低组（<4.0 g/L，A 组）和正常组（≥4.0 g/L，B 组）。在分析的 454 名受试者中，A 组 25 名，B 组 429 名，死亡率分别为 68.0%（17/25 例，P < 0.00001 vs. B 组）和 12.1%（52/429）。 A 组肝细胞癌 (HCC) 死亡率为 66.7%（6/9 例，与 B 组相比，P = 0.01），B 组为 15.8% (3/19)。根据多变量分析，五个因素 - 50 岁或以上、低白蛋白水平 (<4.0 g/L)、AST 水平异常、吸烟史和不饮酒 - 与死亡相关。这五个因素的调整后优势比分别为 20.65、10.79、2.58、2.24 和 2.08，且均具有统计显着性。我们表明，血清白蛋白水平是X镇居民全因死亡的独立危险因素，也是重要的预后指标。应考虑改善低蛋白血症以改善预后。
Hypoalbuminemia has been shown to be associated with increased mortality. We reported a mass screening in 1990 of X town in Japan, which demonstrated a high prevalence of hepatitis C virus (HCV) infection. This follow-up study determined, through a period of 12 years, whether serum albumin levels impact on the life prognosis of the residents of X town. Of the 509 subjects, 69 had died and 55 had moved to other regions by 2002. Therefore, we analyzed 454 people for whom we could confirm life and death between 1990 and 2002. Albumin levels were assigned to two groups, low (<4.0 g/L, group A) and normal (≥4.0 g/L, group B). Of the 454 subjects analyzed, 25 were in group A and 429 in group B and the mortality was 68.0% (17/25 cases, P < 0.00001 vs. group B) and 12.1% (52/429), respectively. Mortality from hepatocellular carcinoma (HCC) was 66.7% in group A (6/9 cases, P = 0.01 vs. group B) and 15.8% (3/19) in group B. According to multivariate analysis, five factors - 50 years or older, low albumin level (<4.0 g/L), abnormal AST level, history of smoking, and absence of alcohol consumption - were associated with death. The adjusted odds ratios for these five factors were 20.65, 10.79, 2.58, 2.24 and 2.08, respectively, and each was statistically significant. We show that the serum albumin level is an independent risk factor for mortality from all causes in the residents of X town and an important prognostic indicator. Improvement of hypoalbuminaemia should be considered for improvement of prognosis.