The relation Between Serum Albumin and Hematopoietic Markers in Children and Women

Abstract

Background: One of the major causes of Anemia is the low availability of the building blocks of red blood cells. Albumin is a major transport and antioxidative protein in the blood. Therefore, low Albumin levels and Anemia may occur simultaneously in malnutrition disorders.

Objectives: The aim of this study is to assess the relation between Albumin and hematopoietic factors in children up to 5 years old and in women in the reproductive age, and to examine the effects of inflammatory markers on this delicate connection.

Methods: A cross-sectional study, LIMA 2023, was conducted in Lebanon on 1405 children aged between 6-59 months and 4232 women aged 10-50 years old. Blood samples were collected to measure Hemoglobin, MCV, MCH, MCHC, WBC, RBC, AGP, CRP, and Albumin. Univariate and multivariate logistic regression were used to analyze the association between Albumin and anemia.

Results: In the children aged 24-59 months, the two groups Mild and Moderate anemia were associated with statistically significant lower levels of Albumin than the Normal group (47.07±2.51). For both age groups, compared with the lowest tertile, the participants in the third tertile had higher hemoglobin, MCV (only in children aged 24 to 59 months), RBC, and lower CRP and AGP. Finally, the children aged 24-59 months showed that even after adjusting for Age, Sex, BMI, inflammatory markers (WBC, CRP, AGP), and hematopoietic factors (MCV, MCH, MCHC) the positive association remained stable (1.21 (1.1-1.3), <0.001), indicating that each unit increase in Albumin increased the likelihood of being non-anemic by 21%, for Albumin levels less than 49g/L. Regarding the women aged 12-50 years old, serum Albumin increased with the decrease in the severity of anemia until reaching the highest level (47 ±2.6 g/L) in the non-anemic group. Compared with the lowest tertile, the participants of the third tertile had higher Hemoglobin, MCV, MCH, RBC, and lower RDW, CRP, and AGP. Furthermore, the Univariate and multivariate logistic regression revealed that Albumin was positively related to the risk of anemia. This association was statistically significant in all of the models for albumin levels (p-value <0.05), even after adjusting for Age, waist circumference, inflammatory markers (WBC, CRP, AGP), and hematopoietic markers (MCV, MCH, MCHC) the positive association remained stable (1.18 (1.1-1.2), <0.001), indicating that each unit increase in Albumin increased the likelihood of being non-anemic by 18%.

Conclusion: Low levels of Albumin, with 47.07±2.5 being the threshold in children aged 6-59 months and 47.07±2.6 g/L in women aged 12-50 years old, may be a consistent risk factor for anemia. Therefore, interventions aimed at improving albumin levels might be beneficial for managing anemia regardless of inflammatory status.