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高氧化应激与中国老年人的虚弱相关。

High oxidative stress is correlated with frailty in elderly chinese.

作者信息

Wu I-Chien, Shiesh Shu-Chu, Kuo Po-Hsiu, Lin Xi-Zhang

机构信息

Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.

出版信息

J Am Geriatr Soc. 2009 Sep;57(9):1666-71. doi: 10.1111/j.1532-5415.2009.02392.x. Epub 2009 Jul 21.

Abstract

OBJECTIVES

To evaluate the relationship between oxidative stress and frailty in elderly people.

DESIGN

Cross-sectional study.

SETTING

Community and hospital-based outpatient clinic.

PARTICIPANTS

Ninety participants aged 65 and older.

MEASUREMENTS

Frailty status was determined according to the presence of weak handgrip strength, weight loss, slow walking speed, exhaustion, and low activity level and was classified as frail (> or =3 criteria), prefrail (1 or 2 criteria), or robust (0 criteria). An oxidative stress marker (serum 8-hydroxy-2'-deoxyguanosine, 8-OHdG), metabolic markers (body mass index, waist-hip ratio, serum lipids, glucose, and albumin), an inflammatory marker (serum high-sensitivity C-reactive protein, hs-CRP), demographic information, and comorbidities (diabetes mellitus, hypertension, congestive heart failure, osteoarthritis, overweight or obesity, impaired fasting plasma glucose, renal insufficiency, and depression) were assessed.

RESULTS

Of the 90 participants, 21 (23.3%) were frail, 56 (62.2%) were prefrail, and 13 (14.4%) were robust. Frail subjects had higher median (range) serum 8-OHdG (2.5 ng/mL (1.5-6.2 ng/mL) vs 2.3 ng/mL (0.5-8.1 ng/mL) and 1.0 ng/mL (0.5-5.3 ng/mL)) and serum hs-CRP (2.5 mg/L (0.3-32.1 mg/L) vs 1.8 mg/L (0.3-50.5 mg/L) and 1.7 mg/L (0.3-4.0 mg/L)) levels, lower mean+/-standard deviation serum albumin levels (4.1+/-0.4 g/dL vs 4.4+/-0.4 g/dL and 4.6+/-0.2 g/dL) and higher mean waist-hip ratios (0.96+/-0.11 vs 0.91+/-0.07 and 0.89+/-0.05)) than prefrail and robust subjects, respectively (P<.05 for all). In multivariable regression analysis, high serum 8-OHdG level was still significantly associated with frailty after adjusting for age, smoking status, comorbidities, waist-hip ratio, serum albumin level, and hs-CRP level.

CONCLUSION

High oxidative stress, characterized by high serum 8-OHdG level, was independently associated with frailty in the selected sample of elderly Chinese.

摘要

目的

评估老年人氧化应激与虚弱之间的关系。

设计

横断面研究。

地点

社区及医院门诊。

参与者

90名65岁及以上的参与者。

测量指标

根据握力弱、体重减轻、步行速度慢、疲惫和活动水平低的情况确定虚弱状态,并分为虚弱(≥3条标准)、衰弱前期(1或2条标准)或健康(0条标准)。评估氧化应激标志物(血清8-羟基-2'-脱氧鸟苷,8-OHdG)、代谢标志物(体重指数、腰臀比、血脂、血糖和白蛋白)、炎症标志物(血清高敏C反应蛋白,hs-CRP)、人口统计学信息和合并症(糖尿病、高血压、充血性心力衰竭、骨关节炎、超重或肥胖、空腹血糖受损、肾功能不全和抑郁症)。

结果

90名参与者中,21名(23.3%)为虚弱,56名(62.2%)为衰弱前期,13名(14.4%)为健康。与衰弱前期和健康受试者相比,虚弱受试者的血清8-OHdG中位数(范围)更高(2.5 ng/mL(1.5 - 6.2 ng/mL)vs 2.3 ng/mL(0.5 - 8.1 ng/mL)和1.0 ng/mL(0.5 - 5.3 ng/mL))以及血清hs-CRP水平更高(2.5 mg/L(0.3 - 32.1 mg/L)vs 1.8 mg/L(0.3 - 50.5 mg/L)和1.7 mg/L(0.3 - 4.0 mg/L)),血清白蛋白平均±标准差水平更低(4.1±0.4 g/dL vs 4.4±0.4 g/dL和4.6±0.2 g/dL),平均腰臀比更高(0.96±0.11 vs 0.91±0.07和0.89±0.05)(所有P<0.05)。在多变量回归分析中,调整年龄吸烟状况、合并症、腰臀比、血清白蛋白水平和hs-CRP水平后,高血清8-OHdG水平仍与虚弱显著相关。

结论

以高血清8-OHdG水平为特征的高氧化应激与所选中国老年样本中的虚弱独立相关。

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