Purpose: Serum albumin can indicate the onset of cancer cachexia, provide information about a patient’s nutritional status, and serve as a biomarker for the prognosis of patients with cancer cachexia. However, the relationship between serum albumin levels and mortality in patients with cancer cachexia remains unclear. We aimed to examine the association of albumin and total protein with 1-year mortality in patients with cancer cachexia.
Patients and Methods: We conducted a nested case–control study using data from a multicenter cancer clinical survey from 2013 to 2018. In total, 266 patients with cancer cachexia who survived for < 1 year and 266 patients who survived for ≥ 1 year were included in this study. The participants were matched by age, sex, tumor type, tumor stage, and hospital site. The crude and adjusted risks of 1-year survival were estimated using odds ratios (ORs) and 95% confidence intervals (95% CIs) using logistic regression, with or without adjustment for covariates.
Results: Logistic regression analysis revealed a significantly negative linear association between albumin level and 1-year mortality in patients with cancer cachexia (p < 0.001). An L-shaped relationship existed between total protein and 1-year mortality, with a turning point at 70.4 g/L. When albumin was divided into quartiles, Q3 (OR: 0.40; 95% CI: 0.24, 0.68; p < 0.001) and Q4 (OR: 0.33; 95% CI: 0.19, 0.55; p < 0.001) were associated with higher 1-year survival than Q1 among patients with cancer cachexia. When total protein was divided into quartiles, Q2 (OR: 0.38; 95% CI: 0.23, 0.64; p < 0.001), Q3 (OR: 0.57; 95% CI: 0.33, 0.96; p = 0.035), and Q4 (OR: 0.43; 95% CI: 0.25, 0.72; p = 0.002) were associated with higher 1-year survival than Q1 among patients with cancer cachexia.
Conclusion: Serum albumin and total protein may predict 1-year survival. Future clinical studies should lead to a more comprehensive understanding of the effects of serum protein levels in patients with cancer cachexia.

Keywords: nutrition, survival, death, cachectic patients


中文翻译：

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癌症恶病质患者的一年死亡率：与白蛋白和总蛋白的关系

目的：血清白蛋白可以指示癌症恶病质的发作，提供有关患者营养状况的信息，并作为癌症恶病质患者预后的生物标志物。然而，癌症恶病质患者血清白蛋白水平与死亡率之间的关系仍不清楚。我们旨在检查白蛋白和总蛋白与癌症恶病质患者 1 年死亡率的关系。
患者和方法：我们使用 2013 年至 2018 年多中心癌症临床调查的数据进行了一项巢式病例对照研究。本研究共纳入 266 名存活 < 1 年的癌症恶病质患者和 266 名存活≥ 1 年的患者。参与者按年龄、性别、肿瘤类型、肿瘤分期和医院地点进行匹配。使用比值比 (OR) 和 95% 置信区间 (95% CI) 使用逻辑回归估计 1 年生存率的粗略和调整后风险，对协变量进行或不进行调整。
结果：Logistic 回归分析显示白蛋白水平与癌症恶病质患者的 1 年死亡率之间呈显着负线性相关（p < 0.001）。总蛋白与1年死亡率呈L型关系，转折点为70.4 g/L。当白蛋白分为四分位数时，Q3 (OR: 0.40; 95% CI: 0.24, 0.68; p < 0.001) 和 Q4 (OR: 0.33; 95% CI: 0.19, 0.55; p < 0.001) 与较高的 1-癌症恶病质患者的年生存率高于 Q1。当总蛋白分为四分位数时，Q2 (OR: 0.38; 95% CI: 0.23, 0.64; p < 0.001), Q3 (OR: 0.57; 95% CI: 0.33, 0.96; p = 0.035) 和 Q4 (OR : 0.43; 95% CI: 0.25, 0.72; p = 0.002）与癌症恶病质患者的 1 年生存率高于 Q1 相关。
结论：血清白蛋白和总蛋白可预测 1 年生存率。未来的临床研究应该能够更全面地了解血清蛋白水平对癌症恶病质患者的影响。

关键词：营养，生存，死亡，恶病质患者