More Serum Albumin, Less MS Risk?

Results from a UK Biobank study published in Frontiers in Immunology indicate that serum albumin levels may correlate with individual risks for multiple sclerosis (MS). These findings expand clinical understandings of the role of albumin in MS and could inform future treatment interventions or risk assessments.¹

Albumin is the most abundant protein found in the blood, and it plays a vital role in maintaining oncotic pressure and transporting enzymes, nutrients, hormones, and more throughout the body.² Liver disease and kidney disease in particular can contribute to depleted albumin levels, but lower levels are also associated with chronic and short-term inflammatory conditions, malnutrition, cancers, and pregnancy.

Albumin is the most abundant protein in the blood | Image Credit: kitsawet - stock.adobe.com

“Furthermore,” the present authors expressed, “albumin acts as an antioxidant, mitigating excessive oxidant stress induced by inflammation in aging neuronal cells. Both oxidative stress and inflammation have been proposed to play a significant role in the MS pathogenesis. Given the ability of antioxidants to reduce inflammatory responses, it is plausible to hypothesize that albumin may confer beneficial effects against MS.”¹

As the authors added, previous studies have explored the influence that albumin might have on inflammatory processes, which could provide benefits to individuals with neurodegenerative conditions; however, there is an inadequate amount of research on the influence of albumin on MS. To expand knowledge in this area, Chen et al conducted a study to evaluate any link between serum albumin levels and individual MS risk.

Data were gathered from the UK Biobank, which features over 500,000 UK residents as part of a population-based prospective cohort study. Enrollees were aged 56.54 years (range, 39-72) on average, and the Biobank’s population was recruited between 2006 and 2010. Data derived from electronic health systems, genotyping, blood sample assays, physical measurements, and questionnaires were included. Of primary interest was an individual’s serum and urine albumin levels, which were measured at baseline. With these measurements, the researchers evaluated outcomes regarding new diagnoses of MS, and follow-ups on MS incidence continued until November of 2022.

The researchers conducted 2 regression analyses, the first of which surveyed 502,356 individuals and the second, 358,200. Throughout an average follow-up of 13.3 years, there were 539 individuals who received an MS diagnosis. These diagnoses typically occurred in those who smoked, had lower levels of vitamin D, and were younger (P < .001). Additionally, those who were more activate had less incidence of MS (P = .001).

For all incidences of MS, participants exhibited serum albumin levels of 44.81 g/L on average compared with 45.2 g/L in non-MS cases (P = .002). Both analyses revealed that each SD of serum albumin was associated with a reduced risk of MS (Model 1: HR, 0.92; 95% CI, 0.87-0.97; Model 2: HR, 0.92; 95% CI, 0.87-0.97).

Among the limitations listed in this study, the authors detailed that their cohort was largely made up of Caucasian participants, which could affect the generalizability of their results. With this aspect in mind, they encourage further research that features more racially and ethnically diverse groups to validate or expand upon their findings. Additionally, they mentioned how albumin levels were only evaluated in urine and serum; investigating these levels in cerebral spinal fluid—due to the neurological nature of MS—could add further insights to their research.

References

1. Chen K, Li C, Zhao B, Shang H. Albumin and multiple sclerosis: a prospective study from UK Biobank. Front Immunol. 2024;15:1415160. doi:10.3389/fimmu.2024.1415160

2. What is albumin? Medichecks. April 5, 2022. Accessed June 25, 2024. https://www.medichecks.com/blogs/biomarkers/what-is-albumin