White Blood Cell Count and C-Reactive Protein Are Independent Predictors of Mortality in the Oldest Old

Willems, Jorien M.; Trompet, Stella; Blauw, Gerard J.; Westendorp, Rudi G.J.; Craen, Anton J. M. de

doi:10.1093/gerona/glq004

Cited by 44 publications

(33 citation statements)

References 32 publications

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“…These biomarkers have been associated with frailty and also with morbidity and mortality in older adults (Willems et al, 2010; Kim et al, 2013; Salazar et al, 2014). The association between time spent in sedentary behavior and increased CRP concentrations and leukocyte counts identified in large population studies (Healy et al, 2011; Pinto Pereira et al, 2012; León-Latre et al, 2014) has received considerable attention in recent years.…”

Section: Discussionmentioning

confidence: 99%

Time Spent Sitting Is Associated with Changes in Biomarkers of Frailty in Hospitalized Older Adults: A Cross Sectional Study

et al. 2017

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Background: Sedentary behavior has gained prominence in the literature as a risk factor for health and mortality independent of physical activity level; however, little is known about the relationship of sedentary behavior with frailty in older adults. The aim of this study was to investigate if time spent sitting can be used as a discriminator of frailty in older hospitalized persons.Methods: The study included 162 hospitalized inpatients aged ≥60 years. Blood samples were taken for analyzing leukocyte counts and serum concentrations of C-reactive protein (CRP). Participants also answered a questionnaire about time spent sitting. Frailty was determined from a combination of CRP concentration and leukocyte count. Receiver operating characteristic (ROC) curves were constructed to analyse the predictive power and cut-points for time spent sitting and the presence of frailty.Results: The areas under the ROC curves indicated that time spent sitting was an independent indicator of frailty (area under curve >0.6). The cut-off points for time spent sitting as an indicator of frailty were >257 min/day for men and >330 min/day for women.Conclusions: Time spent sitting is associated with biomarkers of frailty in persons aged ≥60 years, indicating a need for interventions aimed at reducing sedentary behavior in this age group.

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Section: Discussionmentioning

confidence: 99%

Time Spent Sitting Is Associated with Changes in Biomarkers of Frailty in Hospitalized Older Adults: A Cross Sectional Study

et al. 2017

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“…It has been postulated that neutrophils could produce cytokines, oxidation metabolites, and free radicals that might cause oxidative damages to various tissues (e.g., muscles) and organ systems (Wu et al 2009), and evidently, this process could lead to an increased mortality risk (Babior 1978). It could be a potential limitation for many studies that did not differentiate WBC to scrutinize the effect of different WBC subtypes (Willems et al 2010). It is particularly intriguing to examine whether the identified associations of WBC with mortality in current studies are mostly accounted for by neutrophil or not (Ruggiero et al 2007).…”

Section: Discussionmentioning

confidence: 99%

Use of serum albumin and activities of daily living to predict mortality in long-lived individuals over 95 years of age: a population-based study

Liu

Zhong

et al. 2015

AGE

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Both activities of daily living (ADL) and some blood biomarkers (such as albumin) have been associated with mortality in very elderly people, but scarce data is available on the predictive performance of them in isolation or in combination, which is important for clinicians in decision making. Here, based on prospective mortality data over a 6-year follow-up period from 433 long-lived individuals (LLIs) aged 95+ years in the Rugao longevity cohort, we aimed to evaluate Cox proportional hazard ratios (HRs) and discriminative power (ROC curve) of 14 biomarkers and ADL for all-cause mortality. We found that six biomarkers (total triglyceride, albumin, low-density lipoprotein cholesterol, platelet count, lymphocyte count, and neutrophil count) were associated with mortality with a p < .10 in the univariate model. Significant associations of albumin and neutrophil count with mortality were observed when they were simultaneously included in a multivariate model, with HRs of 0.97 (95 % CI 0.94, 0.99; p = .005) and 1.09 (95 % CI 1.00, 1.18; p = .043). With respect to ADL, the corresponding HR was 1.10 (95 % CI 1.07, 1.14; p < .001). Low albumin (<40 g/L) combined with ADL dependent had a significantly increased mortality risk (HR = 2.19; 95 % CI 1.63, 2.95). Albumin and ADL separately showed good discriminative accuracies (area under the curve [AUC] = 0.68 and 0.66, respectively), and their combination had an increased predictive utility (AUC = 0.73). In conclusion, both albumin and ADL are efficient predictors of all-cause mortality in long-lived populations and their combination further increases discriminative power. The preliminary findings, if validated and translated, would help clinicians to identify the elderly people at varying mortality risk.

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“…In line with the proposed role of inflammation in CKD progression and CVD outcomes, leukocytosis has been predictive of incident and prevalent CKD cases [4,13,14,15]. While C-reactive protein (CRP) and white blood cell count (WBC) have both been used as markers of systemic inflammation, the correlation between the two markers is low [16]. Accordingly, Sabatine et al [17] and Brown et al [18] showed that in subjects with coronary artery disease, elevated WBC even in the context of low CRP was strongly predictive of greater mortality.…”

Section: Introductionmentioning

confidence: 99%

Periodontal Disease, Renal Dysfunction and Heightened Leukocytosis

Salimi

Seliger

et al. 2014

Nephron Clin Pract

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Background: Leukocytosis is a powerful predictor of incident chronic kidney disease (CKD) and related outcomes. However, the association between periodontitis measures and increased leukocytosis in the context of CKD has not been well described. We sought to identify which individual measures of periodontal disease may best associate with reduced estimated glomerular filtration rate (eGFR) and albuminuria, and to test if these measures were associated with increased leukocytosis in subjects with established CKD. Methods: We estimated, among 13,270 participants in the National Health and Nutrition Examination Survey III study, the associations between case-based definition of periodontitis, clinical attachment loss (CAL) and pocket depth (PD) as individual measures of periodontal disease, with renal function measures and leukocytosis. Results: In adjusted multivariate analyses, case-based definition of severe periodontitis was associated with albuminuria (β = 0.003, p = 0.01) but not with eGFR. However, CAL and PD were all individually associated with both albuminuria (β = 0.08, p < 0.001 and β = 0.06, p < 0.001, respectively) and eGFR (β = -0.05, p < 0.001 and β = -0.03, p < 0.001, respectively). We found significant associations between elevated CAL and PD with leukocytosis. Lastly, we found a marked association between the joint presence of CKD and elevated CAL or PD with leukocytosis (odds ratio (OR) 3.3, 95% confidence interval (CI) 1.4-7.5 and OR 3.2, 95% CI 1.1-9.7, respectively). Conclusion: Individual measures of periodontal disease are associated with renal function and heightened leukocytosis in CKD subjects. The significantly added inflammatory burden noted in CKD subjects with periodontal disease argue for targeting periodontitis treatment as part of our multifaceted approach to CKD patients.

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White Blood Cell Count and C-Reactive Protein Are Independent Predictors of Mortality in the Oldest Old

Cited by 44 publications

References 32 publications

Time Spent Sitting Is Associated with Changes in Biomarkers of Frailty in Hospitalized Older Adults: A Cross Sectional Study

Time Spent Sitting Is Associated with Changes in Biomarkers of Frailty in Hospitalized Older Adults: A Cross Sectional Study

Use of serum albumin and activities of daily living to predict mortality in long-lived individuals over 95 years of age: a population-based study

Periodontal Disease, Renal Dysfunction and Heightened Leukocytosis

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