Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.
Servicio de Geriatría, Hospital Universitario de Getafe, Madrid, Spain.
Exp Gerontol. 2020 Jan;129:110782. doi: 10.1016/j.exger.2019.110782. Epub 2019 Nov 18.
Type 2 diabetes mellitus (T2DM) is a leading cause of disability globally. Frailty is a high-impact geriatric condition that increases the risk of negative health outcomes and imposes remarkable health and social burden. Both frailty and T2DM show multifaceted pathophysiology, phenotypic heterogeneity, and fluctuating manifestations that challenge their management, especially when the two conditions co-occur. Muscle wasting and its correlates (e.g., metabolic perturbations and functional decline) that underlie frailty may exacerbates clinical manifestations of T2DM in older people, resulting in worse prognosis. The intrinsic complexity of frailty and T2DM has hampered the identification of clinically meaningful biomarkers to track the clinical progression of the two conditions over time and to monitor the efficacy of pharmacological and lifestyle interventions. Here, we propose an innovative approach for biomarker identification that couples multi-platform analytical determinations with chemometric modeling strategies. This novel multi-marker discovery process is described in the context of the "Metabolic biomarkers of frailty in older people with type 2 diabetes mellitus" (MetaboFrail) study that aimed at identifying metabolic biomarkers of frailty in functionally limited older persons with T2DM.
2 型糖尿病（T2DM）是全球致残的主要原因。衰弱是一种高影响力的老年病况，增加了负面健康结果的风险，并对健康和社会造成显著负担。衰弱和 T2DM 都表现出多方面的病理生理学、表型异质性和波动表现，这对它们的管理构成了挑战，特别是当两种情况同时发生时。衰弱的根本原因是肌肉减少症及其相关因素（例如代谢紊乱和功能下降），可能会使老年人的 T2DM 临床表现恶化，导致预后更差。衰弱和 T2DM 的内在复杂性阻碍了识别有临床意义的生物标志物，以跟踪这两种疾病随时间的临床进展，并监测药物和生活方式干预的疗效。在这里，我们提出了一种创新的生物标志物识别方法，将多平台分析测定与化学计量学建模策略相结合。这种新的多标志物发现过程是在“患有 2 型糖尿病的老年人衰弱的代谢生物标志物”（MetaboFrail）研究的背景下描述的，该研究旨在确定患有 T2DM 的功能受限的老年人衰弱的代谢生物标志物。
