Review Article: Albumin and Its Role in Inflammatory Bowel Disease: The Old, the New, and the Future

IF 3.4 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastroenterology and Hepatology Pub Date : 2025-02-02 DOI:10.1111/jgh.16895

Karla Cameron, Anke L. Nguyen, David J. Gibson, Mark G. Ward, Miles P. Sparrow, Peter R. Gibson

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Abstract

Background

Circulating albumin concentrations are frequently measured in clinical practice. This review explores biochemical properties and physiological roles of albumin, its place in nutritional assessment, current understanding of perturbed circulating concentrations, and role in clinical management, with special focus on patients with inflammatory bowel disease (IBD).

Methods

A detailed literature search was performed.

Results

Albumin is synthesized by hepatocytes and comprises 3% of total body protein. It has a prolonged intravascular half-life (17–19 h) due to neonatal Fc-receptor-mediated salvage and has a multitude of physiological functions. Albumin homeostasis is affected in disease states often resulting in reduced level, which is not a direct marker of malnutrition. In patients with IBD, morbid albumin concentrations provide prognostic information, identification of nonintestinal conditions, guidance to the required aggressiveness of therapy and biologic dosage, monitoring of disease activity, and potential need for therapeutic escalation. Barriers to utilization of morbid albumin levels include the lack of consensus regarding cutoff values and the deficiency of high-quality data in this domain due to the retrospective design of the majority of studies. Serum levels hold greatest clinical potential in prognostication in acute severe ulcerative colitis. The premorbid level in the individual may provide insight into dosing of biologics and potentially enhance interpretation of morbid levels.

Conclusions

Understanding the physiology and pathophysiology of albumin is fundamental to interpreting its circulating levels. The clinical value of its measurement in patients with IBD may be undervalued, as it assists in evaluation of disease severity, prognosis, and therapeutic decision-making.

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综述文章：白蛋白及其在炎症性肠病中的作用：旧的、新的和未来。

背景：在临床实践中经常测量循环白蛋白浓度。这篇综述探讨了白蛋白的生化特性和生理作用，它在营养评估中的地位，目前对循环浓度紊乱的理解，以及在临床管理中的作用，特别关注炎症性肠病（IBD）患者。方法：进行详细的文献检索。结果：白蛋白由肝细胞合成，占机体总蛋白的3%。由于新生儿fc受体介导的挽救，它具有延长的血管内半衰期（17-19小时），并具有多种生理功能。白蛋白稳态在疾病状态下受到影响，通常导致白蛋白水平降低，这不是营养不良的直接标志。在IBD患者中，病态白蛋白浓度提供了预后信息、非肠道疾病的识别、对治疗和生物剂量所需的侵袭性的指导、疾病活动性的监测以及治疗升级的潜在需求。利用病态白蛋白水平的障碍包括对临界值缺乏共识，以及由于大多数研究的回顾性设计，该领域缺乏高质量的数据。血清水平在预测急性严重溃疡性结肠炎中具有最大的临床潜力。个体的发病前水平可以提供对生物制剂剂量的见解，并可能增强对发病水平的解释。结论：了解白蛋白的生理和病理生理是解释其循环水平的基础。测量其在IBD患者中的临床价值可能被低估，因为它有助于评估疾病严重程度、预后和治疗决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.40%

发文量

326

审稿时长

2.3 months

期刊介绍： Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.