Inverse association between serum albumin and future risk of venous thromboembolism: interrelationship with high sensitivity C-reactive protein

Figures & data

Table 1. Baseline participant characteristics by quartiles of serum albumin.

	Quartile 1 mean (SD) or median (IQR) or n (%)	Quartile 2 mean (SD) or median (IQR) or n (%)	Quartile 3 mean (SD) or median (IQR) or n (%)	Quartile 4 mean (SD) or median (IQR) or n (%)
Serum albumin (g/l)	38.1 (2.5)	41.5 (0.5)	43.5 (0.5)	46.5 (1.8)
Questionnaire/prevalent conditions
Age at survey (years)	53.8 (4.8)	53.2 (4.9)	53.1 (5.0)	52.4 (5.5)
Alcohol consumption (g/week)	33.6 (7.6–104.4)	32.4 (4.8–90.5)	28.2 (6.9–86.5)	32.1 (5.6–93.4)
History of diabetes	26 (4.4)	18 (3.6)	21 (3.8)	22 (4.2)
Current smokers	214 (36.2)	155 (30.6)	175 (31.3)	123 (23.7)
History of hypertension	159 (26.9)	148 (29.3)	170 (30.4)	170 (32.7)
History of CHD	151 (25.6)	148 (29.3)	136 (24.3)	112 (21.5)
History of cancer	8 (1.4)	5 (1.0)	16 (2.9)	7 (1.4)
Lipid medication	2 (0.3)	4 (0.8)	4 (0.7)	3 (0.6)
Physical measurements
BMI (kg/m^2)	26.6 (3.4)	26.7 (3.4)	26.8 (3.3)	27.4 (3.8)
SBP (mmHg)	131 (16)	133 (16)	134 (16)	137 (18)
DBP (mmHg)	88 (11)	88 (10)	89 (10)	90 (11)
Physical activity (kj/day)	1151 (615–1941)	1130 (619–1893)	1220 (620–2027)	1272 (672–2126)
Lipid markers
Total cholesterol (mmol/l)	6.04 (1.14)	5.88 (1.08)	5.84 (1.03)	5.85 (1.05)
HDL-C (mmol/l)	1.29 (0.32)	1.30 (0.28)	1.31 (0.31)	1.30 (0.29)
Triglycerides (mmol/l)	1.04 (0.76–1.45)	1.10 (0.82–1.47)	1.10 (0.78–1.59)	1.22 (0.86–1.79)
Metabolic, renal, liver and inflammatory markers
Fasting plasma glucose (mmol/l)	5.36 (1.39)	5.39 (1.31)	5.35 (1.26)	5.32 (1.05)
Serum creatinine (µmol/1)	88.5 (14.5)	89.2 (15.4)	89.6 (12.9)	90.6 (11.6)
Estimated GFR (ml/min/1.73 m^2)	88.0 (17.8)	87.3 (15.8)	86.9 (19.8)	85.4 (14.5)
GGT (U//L)	19 (14–29)	20 (14–33)	20 (15–30)	23 (15–37)
Fibrinogen (g/l)	3.04 (2.72–3.44)	2.96 (2.64–3.37)	2.96 (2.63–3.28)	2.88 (2.57–3.21)
High sensitivity CRP (mg/l)	1.36 (0.78–2.73)	1.38 (0.74–2.51)	1.26 (0.68–2.28)	1.09 (0.64–2.04)

BMI: body mass index; CHD: coronary heart disease; CRP: C-reactive protein; DBP: diastolic blood pressure; GFR: glomerular filtration rate; GGT: gamma-glutamyltransferase; HDL-C: high-density lipoprotein cholesterol; SD: standard deviation; SBP: systolic blood pressure; VTE: venous thromboembolism.

Figure 1. Hazard ratios for baseline levels of serum albumin and venous thromboembolism risk by several participant level characteristics. Hazard ratios are adjusted for adjusted for age, body mass index, systolic blood pressure, history of hypertension, prevalent coronary heart disease, smoking status, history of diabetes, total cholesterol, lipid medication, estimated glomerular filtration rate, physical activity, alcohol consumption, log_e gamma-glutamyltransferase, log_e fibrinogen and prevalent cancer; CHD: coronary heart disease; CI: confidence interval; GGT: gamma-glutamyltransferase; HR: hazard ratio; hs: high sensitivity; Q: quartile; VTE: venous thromboembolism; *: p value for interaction; cut-offs used for age, body mass index, systolic blood pressure, physical activity, alcohol consumption, total cholesterol, gamma-glutamyltransferase, fibrinogen and high sensitivity C-reactive protein are median values.

Table 2. Association of serum albumin and venous thromboembolism.

		Model 1		Model 2		Model 3
Serum albumin (g/l)	Events/total	HR (95% CI)	p value	HR (95% CI)	p value	HR (95% CI)	p value
Per 1 SD decrease	109/2176	1.22 (1.03–1.46)	.025	1.23 (1.02–1.47)	.029	1.22 (1.01–1.46)	.037
Q1 (23–40)	37/591	2.05 (1.14–3.70)	.017	2.06 (1.13–3.76)	.018	2.01 (1.10–3.68)	.023
Q2 (41–42)	29/506	1.91 (1.04–3.53)	.037	1.93 (1.04–3.59)	.036	1.91 (1.03–3.55)	.040
Q3 (43–44)	27/559	1.66 (0.89–3.07)	.110	1.71 (0.92–3.19)	.092	1.69 (0.91–3.15)	.099
Q4 (45–60)	16/520	Ref		Ref		Ref

CI: confidence interval; HR: hazard ratio; Ref: reference; Q: quartile; SD: standard deviation

Model 1: Adjusted for age.

Model 2: Model 1 plus body mass index, systolic blood pressure, history of hypertension, prevalent coronary heart disease, smoking status, history of diabetes, total cholesterol, lipid medication, estimated glomerular filtration rate, physical activity, alcohol consumption, log_e gamma-glutamyltransferase, log_e fibrinogen and prevalent cancer.

Model 3: Model 2 plus log_e high sensitivity C-reactive protein.