Association Of Obese and Morbidly Obese Status with Hypoalbuminemia in Adults Without Liver and Kidney Disease: Obese and Morbidly Obese Status with Hypoalbuminemia in Adults

Muhammad  Maqsood; Husna  Iram; Sundus  Mariyam Haroon; Sadia  Salman; Amanullah  Bhalli; Sadaf  Iqbal

doi:10.54393/pjhs.v3i03.62

Authors

Muhammad Maqsood Department of Internal Medicine and Department of Jinnah Allama Iqbal Institute of Diabetes and Endocrinology, Jinnah Hospital, Lahore, Pakistan
Husna Iram Department of Medicine Children Hospital Lahore, Pakistan
Sundus Mariyam Haroon Department of Internal Medicine and Department of Jinnah Allama Iqbal Institute of Diabetes and Endocrinology, Jinnah Hospital, Lahore, Pakistan
Sadia Salman Department of Internal Medicine and Department of Jinnah Allama Iqbal Institute of Diabetes and Endocrinology, Jinnah Hospital, Lahore, Pakistan
Amanullah Bhalli Department of Internal Medicine and Department of Jinnah Allama Iqbal Institute of Diabetes and Endocrinology, Jinnah Hospital, Lahore, Pakistan
Sadaf Iqbal Department of Internal Medicine and Department of Jinnah Allama Iqbal Institute of Diabetes and Endocrinology, Jinnah Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v3i03.62

Keywords:

Obesity, liver, Kidney Disease, Body, body mass index, global epidemic

Abstract

Obesity is an excessive accumulation of fat in the body and is measured in terms of increased body mass index. Its prevalence is increasing in all age groups and is now considered to be a global epidemic. Albumin is the most abundant plasma protein synthesized in the liver and is customarily utilised to detect malnourishment and severe starvation. It is one of the poor prognostic factors in medical, surgical, and critically ill patients. Objective: To identify the relationship between obesity and morbid obesity and hypoalbuminemia in adults in Pakistan with no signs of liver or kidney disease. Methods: Jinnah Allama Iqbal Institute of Diabetes and Endocrinology (JAIDE), Jinnah Hospital Lahore Pakistan, was chosen for the completion of this cross-sectional study with a time frame of October 2019 to April 2020. 90 patients, ranging between ages of 18 and 70 years, without liver and kidney diseases, were recruited and were divided into three categories, healthy control, obese, and morbidly obese on the basis of BMI. Venous blood samples for albumin were taken. Results: The percentage of hypoalbuminemia was 10.0% in healthy controls, 40.0% in the obese group, and 46.7% in morbidly obese. Hypoalbuminemia rate was significantly higher in obese and morbidly obese groups (p-value 0.005) as compared to healthy controls, independent of age, sex, and diabetes. Conclusions: Upon completion of this study, it was concluded that the morbid obesity and obesity are the independent forecasters of hypoalbuminemia.

References

Romero-Corral A, Somers VK, Sierra-Johnson J, Thomas RJ, Collazo-Clavell ML, Korinek J, et al. Accuracy of body mass index in diagnosing obesity in the adult general population. International Journal of Obesity 2008 Jun; 32(6):959-66. doi: 10.1038/ijo.2008.11.

Ogden CL, Carroll MD, Lawman HG, Fryar CD, Kruszon-Moran D, Kit BK, et al. Trends in Obesity Prevalence Among Children and Adolescents in the United States, 1988-1994 Through 2013-2014. Journal of the American Medical Association 2016 Jun; 315(21):2292-9. doi: 10.1001/jama.2016.6361.

Bray GA. The battle of the bulge: a history of obesity research. Dorrance Publishing Company; 2007.

NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants. Lancet. 2016 Apr; 387(10026):1377-1396. doi: 10.1016/S0140-6736(16)30054-X.

GBD 2015 Obesity Collaborators, Afshin A, Forouzanfar MH, Reitsma MB, Sur P, Estep K, Lee A, et al. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. The New England Journal of Medicine. 2017 Jul; 377(1):13-27. doi: 10.1056/NEJMoa1614362.

Must A, Spadano J, Coakley EH, Field AE, Colditz G, Dietz WH. The disease burden associated with overweight and obesity. Journal of the American Medical Association. 1999 Oct; 282(16):1523-9. doi: 10.1001/jama.282.16.1523.

Bianchini F, Kaaks R, Vainio H. Overweight, obesity, and cancer risk. Lancet Oncology. 2002 Sep; 3(9):565-74. doi: 10.1016/s1470-2045(02)00849-5.

Campos P, Saguy A, Ernsberger P, Oliver E, Gaesser G. The epidemiology of overweight and obesity: public health crisis or moral panic? International journal of epidemiology 2006 Feb; 35(1):55-60. doi: 10.1093/ije/dyi254.

Hossain P, Kawar B, El Nahas M. Obesity and diabetes in the developing world--a growing challenge. The New England Journal of Medicine 2007 Jan; 356(3):213-5. doi: 10.1056/NEJMp068177.

White JV, Guenter P, Jensen G, Malone A, Schofield M; Academy of Nutrition and Dietetics Malnutrition Work Group; A.S.P.E.N. Malnutrition Task Force; A.S.P.E.N. Board of Directors. Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: characteristics recommended for the identification and documentation of adult malnutrition (undernutrition). Journal of the Academy of Nutrition and Dietetics 2012 May; 112(5):730-8. doi: 10.1016/j.jand.2012.03.012.

Sikaris KA. The clinical biochemistry of obesity. The Clinical Biochemist Reviews. 2004 Aug; 25(3):165.

Netzer N, Gatterer H, Faulhaber M, Burtscher M, Pramsohler S, Pesta D. Hypoxia, Oxidative Stress and Fat. Biomolecules. 2015 Jun; 5(2):1143-50. doi: 10.3390/biom5021143.

Koga M, Matsumoto S, Saito H, Kasayama S. Body mass index negatively influences glycated albumin, but not glycated hemoglobin, in diabetic patients. Endocrine Journal. 2006 Jun; 53(3):387-91. doi: 10.1507/endocrj.k05-137.

Miyashita Y, Nishimura R, Morimoto A, Matsudaira T, Sano H, Tajima N. Glycated albumin is low in obese, type 2 diabetic patients. Diabetes Research and Clinical Practice 2007 Oct; 78(1):51-5. doi: 10.1016/j.diabres.2007.02.021.

Koga M, Otsuki M, Matsumoto S, Saito H, Mukai M, Kasayama S. Negative association of obesity and its related chronic inflammation with serum glycated albumin but not glycated hemoglobin levels. Clinica Chimica Acta 2007 Mar; 378(1-2):48-52. doi: 10.1016/j.cca.2006.10.013.

Nishimura R, Kanda A, Sano H, Matsudaira T, Miyashita Y, Morimoto A, et al. Glycated albumin is low in obese, non-diabetic children. Diabetes Research and Clinical Practice 2006 Mar; 71(3):334-8. doi: 10.1016/j.diabres.2005.07.008.

Mosli RH and Mosli HH. Obesity and morbid obesity associated with higher odds of hypoalbuminemia in adults without liver disease or renal failure. Diabetes, Metabolic Syndrome and Obesity 2017 Nov; 10:467-472. doi: 10.2147/DMSO.S149832.

Fu MC, McLawhorn AS, Padgett DE, Cross MB. Hypoalbuminemia Is a Better Predictor than Obesity of Complications After Total Knee Arthroplasty: A Propensity Score-Adjusted Observational Analysis. HSS Journal. 2017 Feb; 13(1):66-74. doi: 10.1007/s11420-016-9518-4.

Brock F, Bettinelli LA, Dobner T, Stobbe JC, Pomatti G, Telles CT. Prevalence of hypoalbuminemia and nutritional issues in hospitalized elders. Revista Latino-Americana de Enfermagem 2016 Aug; 24: e2736. doi: 10.1590/1518-8345.0260.2736.

Herrmann FR, Safran C, Levkoff SE, Minaker KL. Serum albumin level on admission as a predictor of death, length of stay, and readmission. Archives of internal medicine 1992 Jan; 152(1):125-30.

Nicholson JP, Wolmarans MR, Park GR. The role of albumin in critical illness. British journal of anaesthesia. 2000 Oct; 85(4):599-610. doi: 10.1093/bja/85.4.599.

Dietch ZC, Guidry CA, Davies SW, Sawyer RG. Hypoalbuminemia is disproportionately associated with adverse outcomes in obese elective surgical patients. Surgery for Obesity and Related Diseases 2015Aug; 11(4):912-8. doi: 10.1016/j.soard.2014.10.010.

Vincent JL, Dubois MJ, Navickis RJ, Wilkes MM. Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials. Annals of surgery. 2003 Mar; 237(3):319-34. Doi: 10.1097/01.SLA.0000055547.93484.87