Frequency and Clinical Correlates of Hypoalbuminemia in Colorectal Cancer Patients at A Tertiary Care Hospital
Frequency of Hypoalbuminemia in Colorectal Cancer Patients
DOI:
https://doi.org/10.54393/pjhs.v5i12.2493Keywords:
Hypoalbuminemia, Colorectal Cancer, Serum Albumin, Systemic InflammationAbstract
Colorectal cancer is often associated with hypoalbuminemia, a marker of poor nutritional status and systemic inflammation. Low albumin levels in colorectal cancer patients are linked to worse outcomes, including higher morbidity and mortality. Objectives: To assess the frequency of hypoalbuminemia and its association with clinical and biochemical variables among colorectal cancer patients at Liaquat University Hospital, Hyderabad. Methods: This cross-sectional study was conducted from January 14, 2022, to July 13, 2022, at the Department of Surgery, Liaquat University Hospital, Hyderabad. 124 patients who were diagnosed with colorectal cancer aged between 20 to 60 years and of either gender were included in the study. Colorectal cancer was confirmed histopathologically. Patients with other gastrointestinal malignancies, chronic liver diseases, nephrotic syndrome, and those on corticosteroid or immune-suppressive therapy were excluded from the study. Results: The study identified the presence of hypoalbuminemia in n=73 (58.9%) of the patients. Among them, 38 (52.1%) were classified as obese (≥30.0), with a p-value of 0.001. The mean duration of the disease was found to be 49.2 ± 7.10 weeks, which also showed a significant correlation (p=0.01). Additionally, elevated C-reactive protein levels and erythrocyte sedimentation rates showed a strong association with hypoalbuminemia (p=0.001). Hypocalcaemia (34.2%) and hypomagnesemia (27.4%), were significantly associated with hypoalbuminemia. Conclusions: It was concluded that hypoalbuminemia is a prevalent and clinically significant condition among colorectal cancer patients. The high prevalence of hypoalbuminemia is strongly associated with obesity, longer disease duration, rural residency, elevated inflammatory markers, and electrolyte imbalances (hypocalcaemia, hypomagnesemia).
References
Xi Y and Xu P. Global Colorectal Cancer Burden in 2020 and Projections to 2040. Translational Oncology. 2021 Oct; 14(10): 101174. doi: 10.1016/j.tranon.2021.101174.
Hossain MS, Karuniawati H, Jairoun AA, Urbi Z, Ooi DJ, John A et al. Colorectal Cancer: A Review of Carcinogenesis, Global Epidemiology, Current Challenges, Risk Factors, Preventive and Treatment Strategies. Cancers. 2022 Mar; 14(7): 1732. doi: 10.3390/cancers14071732.
Roshandel G, Ghasemi-Kebria F, Malekzadeh R. Colorectal Cancer: Epidemiology, Risk Factors, and Prevention. Cancers. 2024 Apr; 16(8): 1530. doi: 10.3390/cancers16081530.
Khan S, Masood Ai, Tahir M. Association Analysis Between Age and Colorectal Cancer. Age (Years). 2020; 40(54): 77-15.
Khan SZ and Lengyel CG. Challenges in the Management of Colorectal Cancer in Low-and Middle-Income Countries. Cancer Treatment and Research Communications. 2023 Jan; 35: 100705. doi: 10.1016/j.ctarc.2023.100705.
Soeters PB, Wolfe RR, Shenkin A. Hypoalbuminemia: Pathogenesis and Clinical Significance. Journal of Parenteral and Enteral Nutrition. 2019 Feb; 43(2): 181-93. doi: 10.1002/jpen.1451.
Rawla P, Sunkara T, Barsouk A. Epidemiology of Colorectal Cancer: Incidence, Mortality, Survival, and Risk Factors. Gastroenterology Review/Przegląd Gastroenterologiczny. 2019 Jan; 14(2): 89-103. doi: 10.5114/pg.2018.81072.
Das A and Chaudhuri S. Prevalence of Anaemia and Hypoalbuminemia in Newly Diagnosed Carcinoma Cases: A Real World Experience. Journal of Cardiovascular Disease Research. 2023; 14(10): 679-638. doi: 10.48047/jcdr.2023.14.10.80.
Christina NM, Tjahyanto T, Lie JG, Santoso TA, Albertus H, Octavianus D et al. Hypoalbuminemia and Colorectal Cancer Patients: Any Correlation? A Systematic Review and Meta-Analysis. Medicine. 2023 Feb; 102(8): E32938. doi: 10.1097/MD.0000000000032938.
Do Woong Choi J, Kwik C, Vivekanandamoorthy N, Shanmugalingam A, Allan L, Gavegan F et al. Is Preoperative Hypoalbuminemia or Hypoproteinemia a Reliable Marker for Anastomotic Leakage Risk in Patients Undergoing Elective Colorectal Surgery in an Enhanced Recovery After Surgery (Eras) Program? International Journal of Colorectal Disease. 2023 May; 38(1): 152. doi: 10.1007/s00384-023-04450-5.
Almasaudi AS, Dolan RD, Edwards CA, Mcmillan DC. Hypoalbuminemia Reflects Nutritional Risk, Body Composition and Systemic Inflammation and Is Independently Associated with Survival in Patients with Colorectal Cancer. Cancers. 2020 Jul; 12(7): 1986. doi: 10.3390/cancers12071986.
Hu WH, Eisenstein S, Parry L, Ramamoorthy S. Preoperative Malnutrition with Mild Hypoalbuminemia Associated with Postoperative Mortality and Morbidity of Colorectal Cancer: A Propensity Score Matching Study. Nutrition Journal. 2019 Dec; 18: 1-7. doi: 10.1186/s12937-019-0458-y.
Amin MB, Greene FL, Edge SB, Compton CC, Gershenwald JE, Brookland RK et al. The Eighth Edition Ajcc Cancer Staging Manual: Continuing to Build a Bridge from A Population‐Based to A More “Personalized” Approach to Cancer Staging. Ca: A Cancer Journal for Clinicians. 2017 Mar; 67(2): 93-9. doi: 10.3322/caac.21388.
Chen WS, Huang YS, Xu LB, Shi MM, Chen XD, Ye GQ et al. Effects of Sarcopenia, Hypoalbuminemia, and Laparoscopic Surgery On Postoperative Complications in Elderly Patients with Colorectal Cancer: A Prospective Study. Neoplasma. 2020 Jul; 67(4). doi: 10.4149/neo_2020_190908N882.
Kang B, Zhao ZQ, Liu XY, Cheng YX, Tao W, Wei ZQ et al. Effect of Hypoalbuminemia On Short-Term Outcomes After Colorectal Cancer Surgery: A Propensity Score Matching Analysis. Frontiers in Nutrition. 2022 Aug; 9: 925086. doi: 10.3389/fnut.2022.925086.
Constantin GB, Mihailov R, Serban C, Firescu D, Voicu D, Rebegea L et al. The Impact of Hypoalbuminemia On Patients with Complicated Colon Cancers, Operated in Emergency. Romanian Journal of Clinical Research. 2021 Jul; 4(1). doi: 10.33695/rjcr.v4i1.66.
Sofić A, Rašić I, Halilović E, Mujić A, Muslić D. Is Preoperative Hypo-proteinemia Associated with Colorectal Cancer Stage and Postoperative Complications? Medicinski Glasnik. 2021 Aug; 18(2). doi: 10.17392/1353-21.
Miyata T, Hayama T, Ozawa T, Nozawa K, Misawa T, Fukagawa T. Predicting Prognosis in Colorectal Cancer Patients with Curative Resection Using Albumin, Lymphocyte Count and RAS Mutations. Scientific Reports. 2024 Jun; 14(1): 14428. doi: 10.1038/s41598-024-65457-8.
Gremese E, Bruno D, Varriano V, Perniola S, Petricca L, Ferraccioli G. Serum Albumin Levels: A Biomarker to Be Repurposed in Different Disease Settings in Clinical Practice. Journal of Clinical Medicine. 2023 Sep; 12(18): 6017. doi: 10.3390/jcm12186017.
Bénard F, Barkun AN, Martel M, von Renteln D. Systematic Review of Colorectal Cancer Screening Guidelines for Average-Risk Adults: Summarizing the Current Global Recommendations. World Journal of Gastroenterology. 2018 Jan; 24(1): 124. doi: 10.3748/wjg.v24.i1.124.
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