Low serum albumin, aspartate aminotransferase, and body mass are risk factors for frailty in elderly people with diabetes–a cross-sectional study

Yanagita, Ikumi; Fujihara, Yuya; Iwaya, Chikayo; Kitajima, Yuichi; Tajima, Misuzu; Honda, Masashi; Teruya, Yuji; Asakawa, Hideko; Ito, Tomoko; Eda, Terumi; Yamaguchi, Noriko; Kayashima, Yumi; Yoshimoto, Mihoko; Harada, Masaru; Yamanaka, Shōji; Aida, Eiji; Yanase, Toshihiko; Nawata, Hajime; Muta, Koichiro

doi:10.1186/s12877-020-01601-z

Cited by 32 publications

(25 citation statements)

References 37 publications

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“…Biomarkers related to inflammation and endothelial function, such as interleukin-6 (IL-6), soluble intercellular adhesion molecule-1 (s-ICAM-1), E-selectin, and soluble IL-6 receptor, were measured using ELISA (R&D Systems); fibrinogen was assessed by the coagulation method (Sysmex CA-1500; reagent: Dade Behring Company). In addition, serum albumin was measured, and a low serum albumin level (<4.0 g/dL) was defined according to previous research (31). As one of the B vitamins, folate was analyzed by chemiluminescence (Beckman CoulterACCESS R Immunoassay analyser).…”

Section: Biomarkersmentioning

confidence: 99%

Biological Features of the Outcome-Based Intrinsic Capacity Composite Scores From a Population-Based Cohort Study: Pas de Deux of Biological and Functional Aging

et al. 2022

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IntroductionThis study aims to develop and validate an integrative intrinsic capacity (IC) scoring system, to investigate its associations with a wide spectrum of biomarkers and to explore the predictive value of the integrative IC score on 4-year mortality among community dwelling people aged 50 years and older.MethodsWe included 839 adults aged ≥50 years from the Social Environment and Biomarkers of Aging Study (SEBAS) and randomly divided them into derivation and validation cohorts to develop the IC scoring system. The multivariate logistic regression model was used to weight each subdomain (locomotion, sensory, vitality, psychological, and cognition) of IC according to its association with impairments in instrumental activities of daily living (IADL) and to construct the integrative IC score. Age-related biomarkers and genetic markers were compared between IC groups by ordinal logistic regression. A Cox proportional hazard model was used to examine the association between IC and mortality, and subgroup analysis was used to assess the robustness of the results among participants aged 60 years and older.ResultsA 12-score IC scoring system (AUROC = 0.83; Hosmer–Lemeshow goodness-of-fit test p = 0.17) was developed, and higher scores indicated better intrinsic capacity. High interleukin (IL)-6, high E-selectin, low serum albumin and low folate were significantly associated with low IC in the whole sample. However, high IL-6, low serum albumin, low folate, high allostatic load, and APOE ε4 genotype were significantly associated with low IC in those aged 60 years old and older. Compared to the high IC group, the low IC group was significantly associated with all-cause mortality (HR: 2.50, 95% CI: 1.22–5.11, p = 0.01 for all participants; HR 2.19, 95% CI 1.03–4.64, p = 0.04 for participants aged 60 years and older).ConclusionsThe conceptually proposed IC can be easily transformed into a scoring system considering different weights of individual subdomains, which not only predicts mortality but also suggests different pathophysiologies across the life course of aging (inflammation, nutrition, stress, and ApoE4 genotype). An intervention study is needed using the composite IC score to promote healthy aging and determine the underlying pathophysiology.

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Section: Biomarkersmentioning

confidence: 99%

Biological Features of the Outcome-Based Intrinsic Capacity Composite Scores From a Population-Based Cohort Study: Pas de Deux of Biological and Functional Aging

et al. 2022

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“…Hypoalbuminemia was associated with frailty [ 6 ], cognitive impairment [ 7 ], and trace elements deficiency [ 8 ]. It was demonstrated that low serum albumin is a risk factor for frailty in elderly people with diabetes in a Japanese cross-sectional study [ 9 ]. In the longitudinal study, lower levels of serum albumin are associated with future decline in functional performance in older people [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Lower albumin levels are associated with frailty measures, trace elements, and an inflammation marker in a cross-sectional study in Tanushimaru

Yamamoto

Adachi

Enomoto

et al. 2021

Environ Health Prev Med

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Background There is little data on the association between the lower nutrition represented by serum albumin levels and related factors in a general population. The present study aimed to determine whether the albumin level positioned as some kind of biomarker with frailty measures, trace elements, and an inflammation marker. Methods In 2018, we performed an epidemiological survey in 1368 subjects who resided in Tanushimaru, Japan, in which we examined the blood chemistry including albumin, trace elements, hormone levels, and carotid ultrasonography. Albumin levels were categorized into 4 groups (G1 [3.2–3.9 mg/dL], G2 [4.0–4.3 mg/dL], G3 [4.4–4.6 mg/dL], and G4 [4.7–5.3 mg/dL]). The participants underwent measurements of handgrip strength and were tested by asking to walk 5 m. Their cognitive functions were evaluated by the mini-mental state examination (MMSE). Results Multiple stepwise regression analysis demonstrated that albumin levels were significantly and independently associated with age (inversely), systolic blood pressures, estimated glomerular filtration rate (eGFR), MMSE score, frailty measures (handgrip strength), an inflammation marker (high-sensitivity C-reactive protein), hormones (growth hormone (inversely) and insulin-like growth factor-1), and trace elements (calcium, magnesium, iron, and zinc), with a linear trend. Conclusions Lower albumin levels, even in the normal range, were found to be related factors of frailty measures, trace elements, and an inflammation marker in a general population.

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“…Moreover, previous studies have found that serum albumin and body mass index (BMI), both are components of the GNRI, were independently correlated with frailty. 30 , 31 Furthermore, body weight is a common element between structures of the GNRI and the FRAIL scale. Taken together, use of the GNRI, a simple and readily available index, in routine clinical practice may be help clinicians quickly detect patients who are at risk of frailty, and allowing for early nutritional intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Yanagita et al 31 revealed that patients with lower serum albumin had a higher incidence of frailty, suggesting that low serum albumin could be a risk factor for frailty. However, albumin is variant by dehydration, trauma, and hepatic or renal impairment, which prevents it from being a sensitive and specific nutritional marker.…”

Section: Discussionmentioning

confidence: 99%

Association Between Geriatric Nutritional Risk Index and Frailty in Older Hospitalized Patients

Zhao¹,

Hou²,

Zhang³

et al. 2021

CIA

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Objective Previous studies have explored the association between malnutrition and frailty, but no study has investigated whether the Geriatric Nutritional Risk Index (GNRI), a simple and objective nutritional risk screening tool, is associated with the frailty of older adults. The study aimed to examine the relationship between nutrition-related risk, as assessed by the GNRI, and frailty among older hospitalized patients. Methods A cross-sectional study was conducted in the West China Hospital of Sichuan University with 740 patients aged ≥70 years between March 2016 and Jan 2017. Nutritional and frailty status was evaluated with the GNRI and FRAIL scale, respectively. The adjusted and unadjusted ordinal logistic regression analyses were used to examine the relationship between nutritional risk and frailty. The ability of GNRI in detecting frailty was assessed by receiver operating characteristic (ROC) curve analysis. Results The prevalence of low, moderate, and severe nutritional risk among frail patients were 30.1%, 27.6%, and 12.5%, respectively. Ordinal logistic regression analysis showed that malnutrition assessed by the GNRI had a significant association with frailty after adjustment of age, sex, polypharmacy, comorbidity, vision impairment, hearing impairment, cognitive impairment, and depression. In the ROC analysis, the area under the curve for GNRI identifying frailty was 0.698 (95% CI: 0.66–0.74; P <0.001), and the optimal cut-point value was 97.16 (sensitivity: 64.3%; specificity: 66.9%). Conclusion Nutrition-related risk screened by the GNRI was independently associated with frailty. The GNRI could be used as a simple tool in detecting nutritional risk and frailty status of older patients.

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Low serum albumin, aspartate aminotransferase, and body mass are risk factors for frailty in elderly people with diabetes–a cross-sectional study

Cited by 32 publications

References 37 publications

Biological Features of the Outcome-Based Intrinsic Capacity Composite Scores From a Population-Based Cohort Study: Pas de Deux of Biological and Functional Aging

Biological Features of the Outcome-Based Intrinsic Capacity Composite Scores From a Population-Based Cohort Study: Pas de Deux of Biological and Functional Aging

Lower albumin levels are associated with frailty measures, trace elements, and an inflammation marker in a cross-sectional study in Tanushimaru

Association Between Geriatric Nutritional Risk Index and Frailty in Older Hospitalized Patients

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