Change in serum albumin concentration is inversely and independently associated with risk of incident metabolic syndrome

Background Low serum albumin concentration is associated with a high risk of morbidity and mortality from cardiovascular diseases. However, high serum albumin level appears to be linked to metabolic syndrome (MetS). This study aimed to dissect the relative contributions of baseline and change in serum albumin concentration to the risk of incident metabolic syndrome. Methods This was a 5-year (63,060 person-years) retrospective longitudinal study of 12,567 participants without metabolic syndrome, diabetes, or cardiovascular disease who were enrolled in a health screening program. The risk of developing MetS was analyzed according to baseline and change in serum albumin concentration. Results A total of 2582 incident cases of metabolic syndrome developed. The hazard ratio (HR) for incident MetS increased with increasing quartile of baseline serum albumin level compared with those in the lowest quartile, in a fully adjusted model (p for trend = 0.013). The HRs [95% confidence intervals (CIs)] of incident MetS comparing the second, third, and fourth quartiles to the first quartile of change in serum albumin level were 0.478 (0.421–0.544), 0.353 (0.307–0.405), and 0.262 (0.224–0.305) in the fully adjusted model, respectively (p for trend < 0.001). Percent change in serum albumin concentration inversely correlated with percent change in serum level of high-sensitivity C-reactive protein (r = − 3.5444, p < 0.001). Conclusions Although a higher baseline level of serum albumin was linked to increased risk of incident metabolic syndrome, increase in serum albumin concentration might be a protective factor against the risk of MetS.