Serum albumin as a measure of inflammation or malnutrition in inflammatory bowel disease: a cross sectional study

Albumin may be both a marker of malnutrition and a marker of inflammation in various disease states but there has been very little study of the precise etiology of hypoalbuminemia in patients with Crohn’s disease (CD). Malnutrition, a common complication of active CD, can lead to hypoalbuminemia. Inflammation can also lead to low albumin levels, and previous literature in other inflammatory diseases has suggested that inflammation may be more likely than malnutrition to be a primary driver of hypoalbuminemia. This study was a single centre cross sectional study of patients with Crohn’s disease in St. John’s, NL. The main objectives were to examine the association between serum albumin and both inflammation and malnutrition in patients with CD and to determine if serum albumin is an appropriate indicator of one or both of these processes in patients with CD. A total of 45 patients with Crohn’s disease were enrolled in the study. Serum albumin was compared with the subjective global assessment (SGA) for nutritional status, the Crohn’s disease activity index (CDAI), and CReactive Protein (CRP), a marker of inflammation. In our study hypoalbuminemia was independently associated with both malnutrition and inflammation in patients with CD but was most profound in subjects with both malnutrition and active inflammation