Author

Caryn Snyder

Date

January 2009

Document Type

Thesis

Degree Name

M.P.H.

Department

Dept. of Public Health and Preventive Medicine

Institution

Oregon Health & Science University

Abstract

Background Sarcopenia is a term describing the progressive decline of skeletal muscle mass and muscle function with age and is considered to be an important correlate of disability and loss of independence in elderly adults. Serum albumin is the most ubiquitous plasma protein in human serum and low levels have been associated with an increased risk of adverse health outcomes including disability, cardiovascular disease, and mortality. Serum albumin has also been associated with losses of muscle mass and muscle strength and has been proposed as a risk factor for these age-related muscle changes. The purpose of this study was to add to the limited body of research on this topic by examining serum albumin in relation to change in muscle mass, muscle strength, and muscle power. In addition, this study examined the change in serum albumin concentration in relation to these measures of muscle change. Methods The Osteoporotic Fractures in Men (MrOS) Study is a prospective cohort of community-dwelling men aged 65 years and older. The association between baseline serum albumin concentration and change in appendicular skeletal muscle (ASM) mass, grip strength, and leg power over an average of 4.6 years of follow-up was examined in 5534 participants. Two serum albumin measures obtained an average of 2 years apart were available for 1267 participants. The change in serum albumin concentration was examined with the simultaneous change in ASM mass, grip strength, and leg power in this sample of the cohort. Results Baseline serum albumin concentration was not associated with change in ASM mass, grip strength, or leg power after an average of 4.6 years of follow-up in the MrOS study population after adjustment for confounders. These results persisted when evaluating the-same outcomes over an average of 2 years of follow-up in a sample of the cohort. The serum albumin change analysis demonstrated no association between serum albumin change and the concurrent change in ASM mass and grip strength over an average of 2 years of follow-up. Participants with a marked decrease (2 3 g/L) and mild decrease (1-2 g/L) in serum albumin concentration during follow-up exhibited an average loss of -8.9 (95% CI: -25.6, 7.8) watts and -6.3 (95% CI: -21.2, 8.5) watts of leg power, respectively. This loss was statistically significant compared to participants whose serum albumin concentration remained stable (p=O.O2). Conclusions A single low measure of serum albumin was not associated with loss of musclemass, muscle strength, or muscle power in a population of community-dwelling elderly men. The serum albumin change analysis demonstrated null results with measures of muscle mass and muscle strength. The statistically significant association with leg power was small in magnitude and may not be clinically meaningful. The results of this study question the utility of albumin serum protein as a risk factor for the age-related loss of muscle mass and muscle function commonly referred to as sarcopenia.

Identifier

doi:10.6083/M4PC30BF

School

School of Medicine

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