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Dynamic association of serum albumin changes with inflammation, nutritional status and clinical outcomes: a secondary analysis of a large prospective observational cohort study

Yong-Hao Li, Li-Ru Chen, Xin Yang, Hong-Yuan Cui, Zijian Li, Wei Chen, Han-Ping Shi, Ming-Wei Zhu

European Journal of Medical Research, 2025

2,959 participants · 72 citations

Abstract

Serum albumin (ALB) has traditionally been regarded as a marker of nutritional status. However, recent studies suggest its changes are closely linked to inflammation, metabolic dysregulation, and disease severity, limiting its role as a sole indicator of nutritional status. Yet, clinical practice continues to rely on ALB to monitor nutritional interventions, with a paucity of high-quality evidence on its dynamic associations with clinical outcomes. This study aimed to investigate the comprehensive associations of ALB dynamics with inflammation, nutritional status, and clinical outcomes in hospitalized patients, providing evidence to optimize clinical management. This secondary analysis utilized data from a prospective observational cohort study conducted in 34 tertiary hospitals across China between June and September 2014. A total of 2959 patients hospitalized for 7–30 days with complete data were included. Standardized protocols were used to collect demographics, nutritional indices (Nutritional Risk Screening 2002, Subjective Global Assessment), hematology, biochemistry results, and clinical outcomes (complications, length of stay, costs). Subgroup analyses were performed based on inflammatory status changes, nutritional therapy administration, department type, baseline nutritional status, and advanced age. Receiver operating characteristic curves identified cutoff values for infection-related complications. Correlation analyses and multivariable linear regression models…

How strong is the evidence?

Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 2,959 participants or records.

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