Albumin concentrations are primarily determined by the body cell mass and the systemic inflammatory response in cancer patients with weight loss

The association between hypoalbuminemia and poor prognosis in patients with cancer is well recognized. However, the factors that contribute to the fal l in albumin concentrations are not well understood. In the present study, we examined the relationship between circulating albumin concentrations, we ight loss, the body cell mass (measured using total body potassium), and th e presence of an inflammatory response (measured using C-reactive protein) in male patients (n=40) with advanced lung or gastrointestinal cancer. Albu min concentrations were significantly correlated with the percent ideal bod y weight (r=0.390, p<0.05), extent of reported weight loss (r=-0.492, p<0.0 1), percent predicted total body potassium (adjusted for age, height, and w eight, r=0.686, p<0.001), and logo C-reactive protein concentrations (r=-0. 545, p<0.001). On multiple regression analysis, the percent predicted total body potassium and log(10) C-reactive protein concentrations accounted for 63% of the variation in albumin concentrations (r(2) = 0.626, p<0.001). Th e interrelationship between albumin, body cell mass, and the inflammatory r esponse is consistent with the concept that the presence of an ongoing infl ammatory response contributes to the progressive loss of these vital protei n components of the body and the subsequent death of patients with advanced cancer.