Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), P.O. Box 699, 48080 Bilbao, Bizkaia, Spain; BioCruces Health Research Institute, Plaza de Cruces, 48903 Barakaldo, Bizkaia, Spain.
Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), P.O. Box 699, 48080 Bilbao, Bizkaia, Spain.
Exp Gerontol. 2019 Jul 1;121:1-9. doi: 10.1016/j.exger.2019.03.005. Epub 2019 Mar 15.
Frailty is a geriatric syndrome characterized by decreasing functional reserves and increasing vulnerability to falls, injuries and declining health, leading to dependence upon caregivers. Frailty is associated not only with physical decline, but also with cognitive and psychological impairments in aging people. Higher serum adiponectin concentration has been linked to better performance on frailty measures but also to worse cognitive status. Nonetheless, several studies have proposed adiponectin as a frailty biomarker. To further delineate the relationship between adiponectin serum levels and frailty-related parameters, we studied a population of 112 long-term nursing home residents (aged 84.9 ± 6.7) and analyzed their serum adiponectin levels in conjunction with frailty-related parameters including body composition, physical fitness, cognitive function, psychological parameters and quality of life. Frailty was assessed following the Fried Frailty Criteria, the Clinical Frailty Scale and the Tilburg Frailty Indicator. In women, higher serum adiponectin levels were associated with lower body weight, body mass index, body fat mass, fat mass/height, lean mass, lean mass/height and smaller waist circumference and hip circumference (p < 0.05). In men, the association was positive (p < 0.05) between serum adiponectin and percentage of fat mass and negative between serum adiponectin and percentage of lean mass. Interestingly, in men, better cognitive function was inversely related to adiponectin (p < 0.05) while decreased anxiety was linked to a higher concentration of adiponectin in women (p < 0.05). According to the Tilburg Frailty Indicator, frail men had lower levels of adiponectin than those who were not frail (p < 0.05). Variables that predicted adiponectin concentration in multiple regression models were different for women and men. In women, lean mass and anxiety were independent negative predictors of blood adiponectin (β = -0.363, p = 0.002; β = -0.204, p = 0.067, respectively). In men, the Montreal Cognitive Assessment (MOCA) test was the only parameter to remain significant in the regression model (β = -439, p = 0.015). The results of our study show that adiponectin is linked to body composition, cognitive function and anxiety in long-term nursing home residents with differential relationships by sex. Further studies should be conducted to determine whether adiponectin is a valid and reliable frailty biomarker.
衰弱是一种老年综合征，其特征为功能储备减少和易受跌倒、损伤和健康下降的影响，导致依赖护理人员。衰弱不仅与身体衰退有关，而且与老年人的认知和心理障碍有关。较高的血清脂联素浓度与衰弱测量的更好表现有关，但也与更差的认知状态有关。尽管如此，几项研究已经提出脂联素作为衰弱的生物标志物。为了进一步描述脂联素血清水平与衰弱相关参数之间的关系，我们研究了 112 名长期养老院居民（年龄 84.9±6.7 岁）的人群，并分析了他们的血清脂联素水平，同时分析了与衰弱相关的参数，包括身体成分、身体适应性、认知功能、心理参数和生活质量。按照 Fried 衰弱标准、临床虚弱量表和蒂尔堡衰弱指标评估衰弱。在女性中，较高的血清脂联素水平与较低的体重、体重指数、体脂肪量、体脂肪/身高、瘦体重、瘦体重/身高和较小的腰围和臀围相关（p＜0.05）。在男性中，血清脂联素与体脂肪百分比呈正相关（p＜0.05），与瘦体重百分比呈负相关。有趣的是，在男性中，更好的认知功能与脂联素呈负相关（p＜0.05），而焦虑程度降低与女性中较高的脂联素浓度相关（p＜0.05）。根据蒂尔堡衰弱指标，衰弱的男性的脂联素水平低于非衰弱的男性（p＜0.05）。多元回归模型中预测脂联素浓度的变量在女性和男性中是不同的。在女性中，瘦体重和焦虑是血液脂联素的独立负预测因子（β=-0.363，p=0.002；β=-0.204，p=0.067）。在男性中，蒙特利尔认知评估（MOCA）测试是回归模型中唯一显著的参数（β=-439，p=0.015）。我们的研究结果表明，脂联素与长期养老院居民的身体成分、认知功能和焦虑有关，且按性别存在不同的关系。应进一步开展研究，以确定脂联素是否是有效的、可靠的衰弱生物标志物。
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