ArticleAsia Pacific journal of clinical nutrition2026
Serum albumin and hypertension: The mediating roles of BMI, C-reactive protein and extracellular fluid.
Article in Asia Pacific journal of clinical nutrition, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The relationship between serum albumin and hypertension has attracted much attention. We sought to further validate these findings and explore the underlying mediators. METHODS AND STUDY
designThis cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES 1999-2004), including 19,507 participants. Multivariable weighted logistic were employed to investigate the association of serum albumin with hypertension. The potential mediating role of body mass index (BMI), C-reactive protein (CRP), and extracellular fluid (ECF) was explored. Secondary analyses included subgroup analyses and restricted cubic spline (RCS).
resultsSerum albumin per 1 g/L increase was associated with 10% lower hypertension prevalence (OR=0.90, 95%CI:0.89-0.91, p <0.001). This remained significant after full adjustment (including age, sex, race/ethnicity, education level, smoking status, drinking status, sodium in-take, potassium intake, fat intake, total saturated fatty acids [TSFA] intake, carbohydrate intake, protein in-take, energy intake, diabetes, coronary heart disease, creatinine, alanine aminotransferase [ALT], and NHANES cycle)(OR = 0.98, 95%CI: 0.96-1.00, p = 0.031). No evidence of non-linearity was observed in the RCS analysis (p for non-linearity = 0.708). BMI mediated 42.75% (95%CI: 38.19%-48.33%), CRP 12.24% (95%CI: 9.29%-15.43%), and ECF 4.05% (95%CI: 2.74%-5.43%) of the association (all p <0.001). Results were robust in sensitivity analyses.
conclusionsThe serum albumin levels were negatively associated with the prevalence of hypertension. Mediation analyses demonstrated a significant mediating effect of BMI, CRP and ECF, suggesting that serum albumin might be related to hypertension, potentially mediated by BMI, ECF, and CRP.
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