A combination of serum low albumin and above-average cholesterol level was associated with excess mortality

J Clin Epidemiol. 2004 Nov;57(11):1188-95. doi: 10.1016/j.jclinepi.2004.02.019.


Background: There is no population-based prospective study concerning the relation between serum albumin and mortality in a non-Western population, and few previous studies included the subgroup analysis stratified by serum cholesterol level.

Methods: A 13.7-year cohort study was conducted on 6,957 males and females aged 30-59 years from 300 randomly selected areas throughout Japan, who participated in the National Survey on Circulatory Disorders in 1980.

Results: In the group with median and above of total cholesterol, one standard deviation (SD) increment of serum albumin (2.6 g/L for males and 2.4 g/L for females) was inversely associated with all-cause mortality for both males and females (relative risk RR = 0.68 and 0.81: 95% confidence interval CI = 0.53-0.87 and 0.68-0.98), and with cancer mortality for females (RR = 0.74; 95% Cl = 0.57-0.96);and the lowest category of serum albumin (< or = 43 g/L) showed the highest cardiovascular mortality for males (RR = 5.04; 95% CI = 1.04-24.5) among the three albumin categories. These relationships were not evident in the group with total cholesterol level below median.

Conclusion: A combination of a low albumin level and above average cholesterol level, even both within the clinical normal range,is associated with excess mortality in the Japanese general population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • Blood Pressure
  • Cardiovascular Diseases / mortality*
  • Cause of Death
  • Cholesterol / blood*
  • Female
  • Gender Identity
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Neoplasms / mortality*
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Prospective Studies
  • Risk
  • Serum Albumin / analysis*


  • Biomarkers
  • Serum Albumin
  • Cholesterol