Inverse correlation between serum albumin and serum lactate in adults with dengue

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Ifael Yerosias Mauleti
Suhendro Suhendro
Leonard Nainggolan
Martin Rumende


Dengue infection is an acute viral infection, in the natural history of which plasma leakage may occur, resulting in shock followed by tissue hypoxia, with death as the final outcome if not treated properly. The purpose of this study was to determine the correlation of the hematocrit, serum albumin concentration, and the presence of pleural effusion or ascites, with hyperlactatemia in adult dengue patients.

A cross-sectional study was conducted on 62 subjects. The inclusion criteria were: diagnosed dengue viral infection, age >14 years, fever during three consecutive days, and hyperlactatemia. Serum albumin was measured on an Advia 1800 analyzer using the bromocresol green method. The lactate oxidase method was used to determine serum lactate levels. Pleural effusion and/or ascites was determined using an ultrasound scanner (Xario SSA-660 A, Toshiba, Japan). The Pearson correlation test was used to analyze the data.
There was no significant correlation between the hematocrit (r=0.11; p=0.301), serum albumin (r=0.003;p=0.981), and pleural effusion or ascites (r=0.75; p=0.692) with serum lactate levels. However, in patients aged >30 years there was a significant inverse correlation between serum albumin and lactate levels (r =- 0.663;p=0.026).

This study demonstrated a significant inverse correlation between albumin and serum lactate levels in dengue patients aged > 30 years. This can aid in the early recognition and prompt management of at-risk patients to reduce morbidity and mortality.

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How to Cite
Mauleti, I. Y., Suhendro, S., Nainggolan, L., & Rumende, M. (2016). Inverse correlation between serum albumin and serum lactate in adults with dengue. Universa Medicina, 35(2), 75–80.
Original Articles


Kementrian Kesehatan Republik Indonesia. Profil Kesehatan Indonesia 2013. Jakarta: Kementrian Kesehatan Republik Indonesia 2013.

Karyanti MR, Uiterwaal CS, Kusriastuti R, et al. The changing incidence of dengue haemorrhagic fever in Indonesia: a 45-year registry-based analysis. BMC Infect Dis 2014;14: 412. DOI: 10.1186/1471-2334-14-412.

Malavige GM, Fernando S, Fernando DJ, et al. Dengue viral infections. Postgrad Med J 2004;80:588-601.

Murray NEA, Quam MB, Wilder-Smith A. Epidemiology of dengue: past, present and future prospects. Clin Epidemiol 2013;5:299-309.

Martina BE, Koraka P, Osterhaus AD. Dengue virus pathogenesis: an integrated view. Clin Microbiol Rev 2009;22:564-81.

World Health Organization. Dengue guidelines for diagnosis, treatment, prevention and control. Geneva: World Health Organization;2013.

da Silva MMC, Gil LHVG, de Azevedo Marques ET Jr, et al. Potential biomarkers for the clinical prognosis of severe dengue. Mem Inst Oswaldo Cruz 2013;108:755-62.

Conroy AL, Gelvez M, Hawkes M, et al. Host biomarkers are associated with progression to dengue haemorrhagic fever: a nested case-control study. Int J Infect Dis 2015;40:45-53.

World Health Organization. Handbook for clinical management of dengue. Geneva: World Health Organization; 2012.

Yacoub S, Wills B. Predicting outcome from dengue. BMC Med 2014;12:147. DOI: 10.1186/s12916-014-0147-9.

Santosa D, Alwi EH, Idjradinata PS. Validitas kadar laktat darah dalam mendeteksi kebocoran plasma pada infeksi virus dengue anak. Majalah Kedokteran Indonesia 2011;61:58-62.

Michels M, Sumardi U, de Mast Q, et al. The predictive diagnostic value of serial daily bedside ultrasonography for severe dengue in Indonesian adults. PLoS Negl Trop Dis 2013;7:e2277.

Thanachartwet V, Wattanathum A, Oer-areemitr N, et al. Diagnostic accuracy of peripheral venous lactate and the 2009 WHO warning signs for identifying severe dengue in Thai adults: a prospective observational study. BMC Infect Dis 2016;16:46. DOI 10.1186/s12879-016-1386-5.

Puspanjono MT, Latie AT, Sastroasmoro S, et al. Comparison of serial blood lactate level between dengue shock syndrome and dengue haemorrhagic fever (evaluation of prognostic value). Paediatr Indones 2007;47:150-55.

Madiyono B, Moeslichan SMZ, Sastroasmoro S, et al. Perkiraan besar sampel. Dalam Sastroasmoro S, Ismael S, editors. Dasar-dasar metodologi penelitian klinis. 4th ed. Jakarta: Sagung Seto 2011:p. 348-82.

Shapiro NI, Howell MD, Talmor D, et al. Serum lactate as a predictor of mortality in emergency department patients with infection. Ann Emerg Med 2005;45:524-8.

Mikkelsen ME, Miltiades AN, Gaieski DF, et al. Serum lactate is associated with mortality in severe sepsis independent of organ failure and shock. Crit Care Med 2009;37:1670–7.

Okorie ON, Dellinger P. Lactate: biomarker and potential therapeutic target. Crit Care Clin 2011; 27:299–326.

de Azeredo EL, Monteiro RQ, de-Oliveira Pinto LM. Thrombocytopenia in dengue: Interrelationship between virus and the imbalance between coagulation and fibrinolysis and inflammatory mediators. Mediators Inflamm 2015; Article ID 313842, 16 pages

Balasubramanian S, Janakiraman L, Kumar SS, et al. A reappraisal of the criteria to diagnose plasma leakage in dengue hemorrhagic fever. Indian Pediatr 2006;43:334-9.

Thanachartwet V, Oer-areemitr N, Chamnanchanunt S, et al. Identification of clinical factors associated with severe dengue among Thai adults: a prospective study. BMC Infect Dis 2015;15:420. DOI: 10.1186/s12879-015-1150-2.

Thomas L, Brouste Y, Najioullah F, et al. Predictors of severe manifestations in a cohort of adult dengue patients. J Clin Virol 2010;48: 96–9.