Frailty Influences the Relationship between the Soluble Receptor for Advanced Glycation-End Products and Mortality in Older Adults with Diabetes Mellitus.

IF 3.1 3区医学 Q3 GERIATRICS & GERONTOLOGY

Gerontology Pub Date : 2024-04-09 DOI:10.1159/000538292

Lee Butcher, J. Carnicero, Karine Pérès, Stefania Bandinelli, F. García-García, F. Rodríguez‐Artalejo, L. Rodríguez-Mañas, Jorge D Erusalimsky

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引用次数: 0

Abstract

INTRODUCTION Frailty is prevalent among older adults with diabetes mellitus. Elevated serum levels of the soluble receptor for advanced glycation-end products (sRAGE) predict mortality in frail older adults. The evidence that sRAGE is also related to higher mortality in older adults with diabetes mellitus is inconsistent. Therefore, this study explored if frailty status influences the relationship between sRAGE and mortality in older adults with this condition. METHODS We analysed data of 391 participants with diabetes mellitus (median age, 76 years) from four European cohorts enrolled in the FRAILOMIC project. Frailty was evaluated at baseline using Fried's criteria. Serum sRAGE was determined by ELISA. Participants were stratified by frailty status (n = 280 non-frail and 111 frail). Multivariate Cox proportional hazards regression and Kaplan-Meier survival analysis were used to assess the relationship between sRAGE and mortality. RESULTS During 6 years of follow-up, 98 participants died (46 non-frail and 52 frail). Non-survivors had significantly higher baseline levels of sRAGE than survivors (median [IQR]: 1,392 [962-2,043] pg/mL vs. 1,212 [963-1,514], p = 0.008). High serum sRAGE (>1,617 pg/mL) was associated with increased mortality in the whole diabetes sample after adjustment for relevant confounders (HR 2.06, 95% CI: 1.36-3.11, p < 0.001), and there was an interaction between sRAGE and frailty (p = 0.006). Accordingly, the association between sRAGE and mortality was stronger in the frail group compared to the non-frail group (HR 2.52, 95% CI: 1.30-4.90, p = 0.006 vs. HR 1.71, 95% CI: 0.91-3.23, p = 0.099, respectively). Likewise, Kaplan-Meier curves showed a significant difference in survival rates between frail participants with high sRAGE and those with low sRAGE (p = 0.001), whereas no survival difference was seen in the non-frail group (p = 0.09). CONCLUSIONS Frailty status influences the relationship between sRAGE and mortality in older adults with diabetes mellitus. Determination of sRAGE in this population could be a useful tool for risk stratification.

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虚弱会影响高级糖化终产物可溶性受体与老年糖尿病患者死亡率之间的关系。

导言体弱在患有糖尿病的老年人中很普遍。血清中可溶性高级糖化终产物受体（sRAGE）水平升高可预测体弱老年人的死亡率。有证据表明，sRAGE 也与患有糖尿病的老年人死亡率较高有关，但这一证据并不一致。因此，本研究探讨了虚弱状态是否会影响糖尿病老年人的 sRAGE 与死亡率之间的关系。方法我们分析了参加 FRAILOMIC 项目的四个欧洲队列中 391 名糖尿病患者（中位年龄 76 岁）的数据。根据弗里德标准对虚弱程度进行了基线评估。血清 sRAGE 通过酶联免疫吸附法测定。根据虚弱状态对参与者进行分层（n = 280 名非虚弱者和 111 名虚弱者）。结果在 6 年的随访中，98 名参与者死亡（46 名非体弱者和 52 名体弱者）。非幸存者的 sRAGE 基线水平明显高于幸存者（中位数 [IQR]: 1,392 [962-2,043] pg/mL vs. 1,212 [963-1,514], p = 0.008）。在对相关混杂因素进行调整后，高血清 sRAGE（>1,617 pg/mL）与整个糖尿病样本死亡率的增加有关（HR 2.06，95% CI：1.36-3.11，p < 0.001），sRAGE 与虚弱之间存在交互作用（p = 0.006）。因此，与非虚弱组相比，虚弱组的 sRAGE 与死亡率之间的关系更为密切（HR 2.52，95% CI：1.30-4.90，p = 0.006 vs. HR 1.71，95% CI：0.91-3.23，p = 0.099）。同样，Kaplan-Meier 曲线显示，sRAGE 高的体弱者与 sRAGE 低的体弱者的生存率存在显著差异（p = 0.001），而非体弱组的生存率则没有差异（p = 0.09）。在这一人群中测定 sRAGE 可能是进行风险分层的有用工具。

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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.