albumin - publications

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1. PLoS One. 2012;7(4):e35079. Epub 2012 Apr 19.

Association of Serum Albumin with Markers of Nutritional Status among
HIV-Infected and Uninfected Rwandan Women.

Dusingize JC, Hoover DR, Shi Q, Mutimura E, Kiefer E, Cohen M, Anastos K.

Albert Einstein College of Medicine, Bronx, New York, United States of America.

INTRODUCTION: The objectives of this study are to address if and how albumin can
be used as an indication of malnutrition in HIV infected and uninfected Africans.
METHODS: In 2005, 710 HIV-infected and 226 HIV-uninfected women enrolled in a
cohort study. Clinical/demographic parameters, CD4 count, albumin, liver
transaminases; anthropometric measurements and Bioelectrical Impedance Analysis
(BIA) were performed. Malnutrition outcomes were defined as body mass index
(BMI), Fat-free mass index (FFMI) and Fat mass index (FMI). Separate linear
predictive models including albumin were fit to these outcomes in HIV negative
and HIV positive women by CD4 strata (CD4>350,200-350 and <200 cells/µl).
RESULTS: In unadjusted models for each outcome in HIV-negative and HIV positive
women with CD4>350 cells/µl, serum albumin was not significantly associated with
BMI, FFMI or FMI. Albumin was significantly associated with all three outcomes
(p<0.05) in HIV+ women with CD4 200-350 cells/µl, and highly significant in HIV+
women with CD4<200 cells/µl (P<0.001). In multivariable linear regression,
albumin remained associated with FFMI in women with CD4 count<200 cells/µl
(p<0.01) but not in HIV+ women with CD4>200.
DISCUSSION: While serum albumin is widely used to indicate nutritional status it
did not consistently predict malnutrition outcomes in HIV- women or HIV+ women
with higher CD4. This result suggests that albumin may measure end stage disease
as well as malnutrition and should not be used as a proxy for nutritional status
without further study of its association with validated measures.

PMID: 22532840 [PubMed - in process]