Serum albumin as a biomarker of (nutritional status in) sarcopenia.

Introduction: To explore the possible associations between blood markers including albumin, hemoglobulin, creatinine and 25 OH vitamin D with sarcopenia using the ISarcoPRM algorithm.

Materials and methods: A total of 2094 community-dwelling males and postmenopausal females (495 males, 1599 females)aged ≥ 50 years were recruited and their demographic data along with all comorbidities and laboratory evaluations were noted. Functional measurements were also quantified and the ISarcoPRM algorithm was used for the diagnosis/confirmation of the participants into sarcopenic and non-sarcopenic categories.

Results: Sarcopenia was detected in 434 (20.7%) participants and low albumin level in 578 (27.6%) of them. While sarcopenia was detected in 193 (33.4%) of 578 subjects with low albumin levels, and in 241 (15.9%) of 1516 subjects with normal albumin levels (p < 0.001). In the binary logistic regression analysis, among the blood parameters; only albumin levels [OR: 0.932 (95% CI 0.876-0.992) in males (p = 0.026), OR: 0.901 (95% CI 0.862-0.941) in females (p < 0.001)were found to be independently associated with sarcopenia in each gender. After adjusting for sociodemographic and other clinical factors, having low albumin levels(≤ 4.0 g/dL) were independently associated with sarcopenia i.e. 2.368 times (95% CI 1.424-3.939) in males and 2.026 times (95% CI 1.520-2.699) in females (both p < 0.001).

Conclusion: Independent of other factors, low albumin level is associated with sarcopenia i.e. at least two times in both genders. Older and obese adults at risk of malnutrition should be screened/diagnosed and treated early for sarcopenia. Prospective studies are needed for better/prompt management of relevant patients who are prone to significant morbidity and mortality.