Serum Growth Differentiation Factor 15 Levels Predict the Incidence of Frailty among Patients with Cardiometabolic Diseases.

IF 3.1 3区医学 Q3 GERIATRICS & GERONTOLOGY

Gerontology Pub Date : 2024-01-01 Epub Date: 2024-03-15 DOI:10.1159/000536150

Kazuhito Oba, Joji Ishikawa, Yoshiaki Tamura, Yasunori Fujita, Masafumi Ito, Ai Iizuka, Yoshinori Fujiwara, Remi Kodera, Kenji Toyoshima, Yuko Chiba, Masashi Tanaka, Atsushi Araki

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引用次数: 0

Abstract

Introduction: Frailty is a crucial health issue among older adults. Growth differentiation factor 15 (GDF15) is associated with inflammation, oxidative stress, insulin resistance, and mitochondrial dysfunction, which are possible pathogeneses of frailty. However, few longitudinal studies have investigated the association between GDF15 and the incidence of frailty. Therefore, we investigated whether high serum GDF15 levels are associated with the incidence of frailty.

Methods: A total of 175 older adults (mean age: 77 ± 6 years; 63% women) with cardiometabolic diseases and no frailty out of the two criteria at baseline participated. Individuals with severe renal impairment or severe cognitive impairment were excluded. Serum GDF15 levels were measured at baseline. Patients were asked to assess frailty status at baseline and annually during follow-up using the modified version of the Cardiovascular Health Study (mCHS) and the Kihon Checklist (KCL). We examined the association between GDF15 tertiles and each frailty measure during follow-up (median 38-39 months). In the multivariate Cox regression analysis, with the GDF15 tertile groups as the explanatory variables, hazard ratios (HRs) and 95% confidence intervals (CIs) for incident frailty were calculated after adjusting for covariates and using the lowest tertile group as the reference.

Results: During the follow-up period, 25.6% and 34.0% of patients developed frailty, as defined by the mCHS and KCL, respectively. The highest GDF15 tertile group had a significantly higher incidence of mCHS- or KCL-defined frailty than the lowest GDF15 tertile group. Multivariate Cox regression analysis revealed that the adjusted HRs for incident mCHS- and KCL-defined frailty in the highest GDF15 tertile group were 3.9 (95% CI: 1.3-12.0) and 2.7 (95% CI: 1.1-6.9), respectively.

Conclusion: High serum GDF15 levels predicted the incidence of frailty among older adults with cardiometabolic diseases and could be an effective marker of the risk for frailty in interventions aimed at preventing frailty, such as exercise and nutrition.

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血清生长分化因子 15 水平可预测心脏代谢疾病患者的虚弱发生率

导言虚弱是老年人的一个重要健康问题。生长分化因子 15（GDF15）与炎症、氧化应激、胰岛素抵抗和线粒体功能障碍有关，这些可能是导致虚弱的病因。然而，很少有纵向研究调查 GDF15 与虚弱发病率之间的关系。因此，我们研究了高血清 GDF15 水平是否与虚弱的发生率有关：共有 175 名患有心脏代谢疾病的老年人（平均年龄：77 ± 6 岁；63% 为女性）参加了此次研究。患有严重肾功能损伤或严重认知障碍的人被排除在外。基线测量血清 GDF15 水平。要求患者在基线时评估虚弱状况，并在随访期间每年使用心血管健康研究改良版（mCHS）和Kihon核对表（KCL）进行评估。我们研究了随访期间（中位数为 38-39 个月）GDF15 三分层与各项虚弱指标之间的关系。在多变量 Cox 回归分析中，以 GDF15 三分层组为解释变量，在调整协变量并以最低三分层组为参照后，计算了发生虚弱的危险比 (HR) 和 95% 置信区间 (CI)：在随访期间，分别有 25.6% 和 34.0% 的患者出现了 mCHS 和 KCL 所定义的虚弱。GDF15最高三分位数组的mCHS或KCL定义的虚弱发生率明显高于GDF15最低三分位数组。多变量考克斯回归分析显示，GDF15最高三分位数组发生mCHS和KCL定义的虚弱的调整HR分别为3.9（95% CI：1.3-12.0）和2.7（95% CI：1.1-6.9）：高血清GDF15水平可预测患有心脏代谢疾病的老年人的虚弱发生率，并可在运动和营养等旨在预防虚弱的干预措施中作为虚弱风险的有效标志物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gerontology 医学-老年医学

CiteScore

6.00

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： In view of the ever-increasing fraction of elderly people, understanding the mechanisms of aging and age-related diseases has become a matter of urgent necessity. ''Gerontology'', the oldest journal in the field, responds to this need by drawing topical contributions from multiple disciplines to support the fundamental goals of extending active life and enhancing its quality. The range of papers is classified into four sections. In the Clinical Section, the aetiology, pathogenesis, prevention and treatment of agerelated diseases are discussed from a gerontological rather than a geriatric viewpoint. The Experimental Section contains up-to-date contributions from basic gerontological research. Papers dealing with behavioural development and related topics are placed in the Behavioural Science Section. Basic aspects of regeneration in different experimental biological systems as well as in the context of medical applications are dealt with in a special section that also contains information on technological advances for the elderly. Providing a primary source of high-quality papers covering all aspects of aging in humans and animals, ''Gerontology'' serves as an ideal information tool for all readers interested in the topic of aging from a broad perspective.