ABSTRACT Objective: To determine if there is any significant association between stroke and both hypoalbuminema and hypoproteinemia. Patients and Methods: Total serum proteins “T.S.P.” and serum albumin were measured for 65 patients with stroke who were admitted to the medical and neurological wards at Baghdad Teaching Hospital in the Medical City from November 2003 to October 2004. Careful history was obtained and proper clinical examinations were done. Serum albumin, T.S.P., blood sugar, renal function, liver function and general urine examination “G.U.E.” were tested within 48 - 72 hours of the start of patient symptoms. These patients with hepatic and renal dysfunction and those with diabetes mellitus were excluded. The results were compared with the results obtained from control group, which consisted of 40 persons of matched age and sex. By application pf chi square test “X” to see the association of serum albumin with cigarette smoking, age, hypertension and the presence of carotid bruit. Results: The mean serum level of T.S.P. and serum albumin of those with stroke was 6.42 ± 0.322 g/dl, 3.26 ± 0.251 g/dl respectively, which was significantly lower than T.S.P. and serum albumin of the control “mean = 7.8 ± 0.257 g/dl, 4.73 ± 0.206 g/dl respectively” [P < 0.001]. This study reveals that there is an inverse relationship between the age [X2 = 25.14, P < 0.005], number of cigarettes [X2 = 15.57, P < 0.025] and the blood pressure with serum albumin P < 0.0005, and the presence of carotid bruit is associated with low level of albumin P < 0.005 “Fisher’s test”. Conclusion: Hypoalbuminemia and hypoproteinemia are significantly associated with stroke.
Cite this paper
Aboud, H. , Mohammed, H. , Kamil, M. and Hassan, B. (2018) The Significance of Hypoalbumineamia and Hypoproteinemia in Patients with Stroke. Neuroscience and Medicine, 9, 105-115. doi: 10.4236/nm.2018.93011.
 Wyngaarden, J.B. and Smith, L.H. (1985) Cecil Textbook of Medicine. 17th Edition, Saunders Company, Philadelphia.
 Rose, R. and Glomest, J.A. (1976) Pathogenesis of Atherosclerosis. The New England Journal of Medicine, 295, 369-377.
 Ross, R. (1993) The Pathogenesis of Atherosclerosis: A Prospective for the 1990s. Nature, 362, 801-809. https://doi.org/10.1038/362801a0
 Harker, L.A., Slichtor, S., Scott, C.R., et al. (1974) Homocysteinemia, Vascular Injury and Arterial Thrombosis. The New England Journal of Medicine, 291, 537-543.
 Shaper, A.G., Wannamethee, S.G. and Walker, M. (1997) Body Weight: Implications for the Prevention of Coronary Heart Diseases, Stroke, and Diabetes Mellitus in Cohort Study of Middle Aged Men. BMJ, 314, 1311-1317.
 Ockene, I.S. and Miller, NH. (1997) Cigarette Smoking, Cardiovascular Disease, and Stroke: A Statement for Healthcare Professionals from the American Heart Association. American Heart Association Task Force on Risk Reduction. Correlation, 96, 3243-3247.
 Kannel, W.B., Castelli, W., Gordon, T., et al. (1991) Serum Cholesterol, Lipid Protein and Coronary Heart Diseases: The Framingham Study. Annals of Internal Medicine, 74, 1-12. https://doi.org/10.7326/0003-4819-74-1-1
 Miller, N.E. (1987) Association of High Density Lipoprotein Subclasses and Apolipoproteins with IHD and Atherosclerosis. American Heart Journal, 113, 589-597.
 Meller, G.J. and Miller, N.E. (1975) Plasma-HDL Concentration and the Development of 1HD. The Lancet, 1, 9-19.
 Mc Mahan, S., Pete, R., Cutter, J., et al. (1990) Blood Pressure, Stroke and Coronary Heart Diseases. Part I. Prolonged Differences in Blood Pressure: Prospective Observational Studies Corrected for the Progressive Dilution Bias. The Lancet, 335, 765-774. https://doi.org/10.1016/0140-6736(90)90878-9
 Molitch, M.E. (1997) Management of Early Diabetic Nephropathy. The American Journal of Medicine, 102, 392-398. https://doi.org/10.1016/S0002-9343(97)00118-6
 Cooper, M.E. (1998) Pathogenesis, Prevention, and Treatment of Diabetic Nephropathy. The Lancet, 352, 213-218. https://doi.org/10.1016/S0140-6736(98)01346-4
 Dockort, T., Yokoyama, H., Skovjenset, J., et al. (1996) Control Study of Predictive Value of Urinary Albumin Excretion for Atherosclerotic Vascular Diseases Patients with Insulin Dependant Diabetes Mellitus. BMJ, 312, 871-874.
 Mathisen, E.R., Ronn, B., Jensen, J., Storm, B. and Deckert, J. (1990) Relationship between Blood Pressure and Urinary Albumin Excretion in Development of Microalbuminuria. Diabetes, 39, 245-249. https://doi.org/10.2337/diab.39.2.245
 Mattock, M.B., Morrish, N.J., Viberti, G.C., Keen, H., Fitzgerald, A.P. and Jackson, G. (1992) Prospective Study of Microalbuminuria as Predictor of Mortality in NIDDM. Diabetes, 41, 736-741. https://doi.org/10.2337/diab.41.6.736
 Yudkin, J.S., Forrest, R.D. and Jackson, C.A. (1988) Microalbuminuria as a Predictor of Vascular Disease in Non Diabetic Subjects. The Lancet, 2, 530-533.
 Martin, D.W. (1981) The Plasma Proteins. In: Mayer, P.A., David, W. and Rodwell, V.W., Eds., Harper’s Review of Biochemistry, 18th Edition, Lang Medical Publications, 54-56.
 Austein, F., Allumin, H. and Ian, D.K. (1988) Biochemistry. 2nd Edition, Wiley Media, New York.
 Abrahams, W. (1978) Plasma Protein. In: Abraham, W., Ed., Principles of Biochemistry, 6th Edition, McGrew-Hill, New York, 145-147.
 Guyten, A.C. (1986) Circulation. In: Guyton, A.C., Ed., Textbook of Medical Physiology, 7th Edition, WB Saunders, Philadelphia, 89-111.
 Walter, J.B. and Israel, M.S. (1987) The Plasma Proteins. In: Walter, J.B., Ed., General Pathology, 6th Edition, Churchill Livingstone, London, 32-39.
 Daniel, K. (1998) Derangements of Hepatic Metabolism. In: Fauci, A.S., Bramwald, E., et al., Eds., Harrison’s Principles of Internal Medicine, MCGrew Hill, New York, 222-239.
 Philips, A., Shaper, A.G. and Whincup, P.H. (1989) Association between Serum Albumin and Mortality from Cardiovascular Disease, Cancer & Other Cause. The Lancet, 2, 1434-1436. https://doi.org/10.1016/S0140-6736(89)92042-4
 Gillum, R.F. and Makue, D.I.M. (1992) Serum Albumin, Coronary Heart Disease and Death. American Heart Journal, 123, 507-513.
 Oas, S.O., Prabla, K. and Sugathan, T.N. (1997) Significant Hypoalbuminemia, Hypoproteinemia Associated with Myocardial Infarction in a Kuwait Arabs Population. Annals of Saudi Medicine, 17, 124-125.
 Lindberg, G., Eklund, G.A., Gulberg, B. and Rastaml, L. (1991) Serum Sialic Acid Concentration and Cardiovascular Mortality. BMJ, 302, 143.
 Orekhor, A.N., Torter, V.V. and Mukhim, D.N. (1991) Desialylated Low Density Lipoprotein-Naturally Occurring Modified Lipoprotein with Atherogenic Potency. Atherosclerosis, 86, 153-161. https://doi.org/10.1016/0021-9150(91)90211-K
 Fleck, A., Rainer, G., Hawker, F., et al. (1985) Increased Vascular Permeability and Major Cause of Hypoalbuminemia in Disease and Injury. The Lancet, 1, 781-783.
 Schitzer, J.E. and Punney, E. (1992) Quantitation of Specific Finding of Orosemanacid to Cultured Microvascular Endothelium, Role in Capillary Permeability. 32, H48-H55.
 Erenil, G., Erebas, D. and Aysel, A. (1993) Free Radials and Antioxidant Systems. Materia Medica Palana, 1, 37-43.
 Anthony, S., Fauci, E.B., et al. (1998) Laboratory Data of Clinical Significant. In: Kasper, D., et al., Eds., Harrison’s Principles of Internal Medicine, 18th Edition, McGrew Hill, New York, 463-471.
 Corti, M.-C., et al. (1994) Serum Albumin and Physical Disability as Predictors of Mortality in Older Persons. JAMA, 272, 1036.
 Robert, L.K. (1994) Changes Associated with Normal Aging. In: Robert, L.K., Joseph, G.O. and Itamar, B.A., Eds., Essential of Clinical Geriatrics, 3rd Edition, McGrew Hill Inc., New York, 53-61.
 Heil, M.R. (1998) Geriatric Medicine. In: Anthony, S.F., Brunwald, E., et al., Eds., Harrison’s Principles of Internal Medicine, 14th Edition, McGrew Hill, New York, 95-117.
 William, W.P. (1997) Nonlipolipoprotein Risk Factors of Coronary Heart Disease: Evaluation and Management. American Journal of Medicine, 102, 7-13.
 Alan, R. and James, S.F. (1997) The Secondary Prevention of Coronary Artery Disease. American Journal of Medicine, 102, 572-580.
 Teresa, H., Beatrice, N., Mike, H., Cornelins, C., Habib, B. and Geraldine, G. (1997) Microalbuminuria in Patients with Non Insulindependant Diabetes Mellitus Relates to Nocyurnal Systolic Blood Pressure. American Journal of Medicine, 102, 531.
 Adnan, A., Peter, A., Saod, A.R. and Thir, O. (1996) Carotid Bruit and Ischemic Cerebrovascular Disease. Annals of Saudi Medicine, 16, 218-220.
 Halbrook, J.H., Grundy, S.M., Heineker, C.H., Kannell, W.B. and Streng, J.P. (1992) Cigarette Smoking and Cerebrovasular Disease, Statement for Heart Professionals. Circulation, 86, 1664-1669. https://doi.org/10.1161/01.CIR.86.5.1664