Lower serum albumin concentration and change in muscle mass: the Health, Aging and Body Composition Study

Low albumin concentrations in older persons increase the risk of poor health outcomes, including functional decline.

The aim of the study was to investigate the association between serum albumin concentration and skeletal muscle loss (sarcopenia) in old age.

Serum albumin concentration was measured in 1882 black and white men and women aged 70-79 y participating in the Health, Aging and Body Composition Study. Five-year changes in appendicular skeletal muscle mass (ASMM), total-body fat-free mass (FFM), and trunk lean mass (TLM) were measured by using dual-energy X-ray absorptiometry. Confounders included health and lifestyle factors, which are markers of inflammation and protein intake.

A low albumin concentration (< 38 g/L) was observed in 21.2% of the study participants. After adjustment for confounders, the mean (+/-SE) change in ASMM was -82 +/- 26 g per 3-g/L lower albumin concentration (P = 0.002). This association remained after persons with a low albumin concentration (< 38 g/L) were excluded. The decline in ASMM in subjects with low albumin concentrations was almost 30% higher (-930 +/- 56 g) than that in those with albumin concentrations > or = 42 g/L (-718 +/- 38 g; P < 0.01). The association between albumin and change in ASMM remained after additional adjustment for weight change. A weak association was observed for FFM, whereas no association was observed for TLM, which suggests a specific role of albumin in skeletal muscle change.

Lower albumin concentrations, even above the clinical cutoff of 38 g/L, are associated with future loss of ASMM in older persons. Low albumin concentration may be a risk factor for sarcopenia.