Abstract:Aim To analyze the prognostic value of hypoalbuminemia for long-term outcome in elderly patients with chronic heart failure after propensity score stratification. Methods 1271 consecutive elderly patients with chronic heart failure were enrolled and divided into two groups according to serum albumin concentration on admission ＜35 g/L(hypoalbuminemia group) and ≥35 g/L(normoalbuminemia group). Propensity score stratification was conducted to reduce confounding bias. And then COX proportional-hazards regression modeling was used to evaluate the prognostic value of hypoalbuminemia for long-term outcome for the pre-stratification and post-stratification data. Results Before stratification, hypoalbuminemia group was older, had higher NYHA status, direct bilirubin, alkaline phosphatase, creatinine, BNP, less hypertension; lower hemoglobin, indirect bilirubin, TC, serum sodium on admission, EF on admission; faster heart rate on admission. During the median 23.9-month follow-up, there were 165 deaths(13.0%) for all causes, 76 in hypoalbuminemia group(46.1%), 260 in normoalbuminemia group(23.5%). The univariate COX regression analysis indicated that hypoalbuminemia was the strong independent risk for long-term mortality in elderly patients with chronic heart failure(HR was 2.540, 95% CI was 1.966~3.282, P<0.001). Adjusted for propensity score, the multivariate COX regression analysis indicated that the risk of long-term mortality in hypoalbuminemia patients increased 56.1% than the normoalbuminemia patients(HR was 1.561, 95%CI was 1.186~2.054, P＝0.001). After adjustment using propensity score stratification, the overall HR was 1.724, 95%CI was 1.311~2.268, which indicated that the risk of long-term mortality in hypoalbuminemia patients increased 0.724-time than the normoalbuminemia patients. Conclusions Hypoalbuminemia indicated the increasing of long-term mortality in elderly patients with chronic heart failure. It was possible to improve the prognosis of elderly patients with chronic heart failure by correcting hypoalbuminemia.

Abstract:Aim To investigate the relationship between heavier proteinuria or hypoalbuminemis and serum lipid abnormalities in primary nephrotic syndrome.Methods Serum albumin, total cholesterol (TC),low density lipoprotein cholesterol (LDLC) and 24-hour urinary protein content were assayed in nephrotic syndrome patients (n=20) and healthy controls (n=20).Results Hyperlipidemia is a consistent feature of the nephrotic syndrome patients. 24-hour urinary protein content was positive correlated with the level of serum TC (r=0. 43, p<0.05), but no statistically significance was observed between proteinuria and serum LDLC (r =0. 37, P >0.05). The level of serum albumin was inversely significantly correlated with both the level of serum TC and LDLC (r=-0.69, p<0. 01, r=-0. 51, p<0. 01, respectively).Conclusion There were correlated relationship between proteinuria or hypoalbuminemia and serum lipid abnormalities in nephrotic syndrome.