Relationship Between Serum Albumin and Bone Mineral Density in Postmenopausal Women and in Patients with Hypoalbuminemia

Abstract

Some discrepancies exist about the relationship between serum albumin level and the pathogenesis of osteoporosis; moreover, most of the studies available have especially concerned patients with osteoporosis, often associated with fractures. Our study, therefore, aims to investigate the presence of a relationship between serum albumin level and bone mineral density in a group of healthy women (n=650; mean age 59.0 +/- 7.4 years) who voluntarily underwent screening for osteoporosis only because they were menopausal (11.2 +/- 7.4 years since menopause) and, for comparison, in a group of outpatients (n = 44; mean age 57.6 +/- 7.0 years; 9.1 +/- 6.7 years since menopause) with hypoalbuminemia associated with diseases. The results show a lack of any relationship in healthy women between serum albumin value and bone mineral density; the lack of correlation was also shown when the postmenopausal women were down into normal, osteopenic and osteoporotic (WHO criteria) or in hypo, normal and hyperalbuminemic. The only significant parameters associated with lower bone mineral density, in fact, were age and years since menopause (p<0.0001 and p<0.0001 respectively at lumbar spine and p<0.02 and p<0.001 at femoral neck level). In the group of patients with hypoalbuminemia associated with diseases, on the other hand, a relationship between reduced bone mineral density and hypoalbuminemia was found (p<0.01 and p<0.05 respectively at lumbar spine and femoral neck). In conclusion, in healthy postmenopausal women the serum albumin level does not play a significant role in the pathogenesis of bone density reduction, which is mainly due to the number of years since menopause and advancing age. The hypoalbuminemia may be related to the reduction of bone mass only in the subjects affected by diseases associated with a significant albumin reduction.

Serum Albumin and Body Weight as Biomarkers for the Antemortem Identification of Bone and Gastrointestinal Disease in the Common Marmoset

“…Hypoalbuminemia has been reported in humans with osteopenia [52] and has been associated with increased disease severity and higher mortality in both human and canine patients with inflammatory bowel disease [53]–[56]. Additionally, low serum albumin has been found to be a risk factor for low bone mineral density, a recognized complication of Crohn’s disease in humans [57].…”

Bone loss after renal transplantation: role of hyperparathyroidism, acidosis, cyclosporine and systemic disease

“…It is possible that these factors are causal, the common pathogenic pathway being malnutrition or low physical activity, though it has been suggested that atherosclerosis is a consequence of hyperparathyroidism [22]. Hypoalbuminemia in systemic disease is related to osteopenia [23] as is diabetes [2], but atherosclerosis and renovascular disease have not previously been associated. Acidosis is well recognised as a cause of bone loss [24] and bicarbonate therapy can improve bone metabolism [25].…”

Nomogram for predicting reoperation following internal fixation of nondisplaced femoral neck fractures in elderly patients

“…However, data on the exact reason remains scant. Previous studies showed lower albumin level was associated with low BMD and recurrent falls after low-energy injury [ 36 , 37 ]. In addition, we hypothesize that euthyroid sick syndrome (ESS) might be responsible for reoperation in patients with hypoalbuminemia.…”