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一种潜在的尿生物标志物,用于确定老年人的虚弱状态。

A potential urinary biomarker to determine frailty status among older adults.

机构信息

Department of Geriatrics, Peking Union Medical College, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China.

Department of Geriatrics, Taikang Rehabilitation Hospital, No. 2 Jingrong Street, Changping District, Beijing 102299, China.

出版信息

Arch Gerontol Geriatr. 2020 May-Jun;88:104038. doi: 10.1016/j.archger.2020.104038. Epub 2020 Feb 25.

Abstract

BACKGROUND

Association of oxidative stress biomarkers with aging and several age-related diseases is well documented. However, the possible role of these factors on frailty status in older adults has not been extensively studied.

OBJECTIVE

To evaluate whether urinary 8-oxo-7,8-dihydroguanosine (8-oxo-Gsn), a biomarker of RNA oxidative damage, was independently associated with frailty.

METHODS

In this cross-sectional analysis, frailty phenotype was assessed among 230 participants living in a senior community. Participants received a comprehensive geriatric assessment. Serum high-sensitivity C-reactive protein (hsCRP), white blood cell count (WBC), urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine, and 8-oxo-Gsn were measured.

RESULTS

Participants' mean age was 83.9 ± 4.4 years. In total, 33 % were frail, 45 % were pre-frail, and 22 % were non-frail. Urinary 8-oxo-Gsn, serum hsCRP, and WBC were significantly higher in the frail group than in the non-frail and pre-frail groups (p-values < 0.05). Adjusting for age, sex, and Charlson comorbidity index, statistically significant positive associations with frailty were observed for urinary 8-oxo-Gsn (odds ratio [OR]: 1.70, 95 % confidence interval [CI]: 0.264-0.732) and hsCRP (OR: 1.337, 95 % CI: 0.089-0.412). Urinary 8-oxo-Gsn of 3.175 μmol/mol had the optimal predictive value for frailty, with an area under the receiver operating characteristic curve (AUC) of 0.72 (95 % CI: 0.649-0.788). The prediction probability combining urinary 8-oxo-Gsn and a simple question evaluating exhaustion had the optimal predictive value for frailty, with an AUC of 0.90 (p < 0.001, 95 % CI: 0.85-0.95).

CONCLUSION

Urinary 8-oxo-Gsn level was independently associated with frailty. This urinary biomarker may be a promising indicator of frailty.

摘要

背景

氧化应激生物标志物与衰老和多种与年龄相关的疾病之间的关联已有充分的文献记载。然而,这些因素对老年人虚弱状态的可能作用尚未得到广泛研究。

目的

评估尿液 8-氧-7,8-二氢鸟苷(8-oxo-Gsn),一种 RNA 氧化损伤的生物标志物,是否与虚弱独立相关。

方法

在这项横断面分析中,对居住在老年社区的 230 名参与者进行了虚弱表型评估。参与者接受了全面的老年评估。测量了血清高敏 C 反应蛋白(hsCRP)、白细胞计数(WBC)、尿液 8-氧-7,8-二氢-2'-脱氧鸟苷和 8-氧-Gsn。

结果

参与者的平均年龄为 83.9±4.4 岁。共有 33%的人虚弱,45%的人虚弱前期,22%的人不虚弱。尿液 8-oxo-Gsn、血清 hsCRP 和 WBC 在虚弱组中明显高于非虚弱组和虚弱前期组(p 值均<0.05)。在校正年龄、性别和 Charlson 合并症指数后,尿液 8-oxo-Gsn(比值比[OR]:1.70,95%置信区间[CI]:0.264-0.732)和 hsCRP(OR:1.337,95%CI:0.089-0.412)与虚弱呈显著正相关。尿液 8-oxo-Gsn 为 3.175μmol/mol 时对虚弱具有最佳预测价值,受试者工作特征曲线(ROC)下面积(AUC)为 0.72(95%CI:0.649-0.788)。结合尿液 8-oxo-Gsn 和评估疲劳的简单问题的预测概率对虚弱具有最佳预测价值,AUC 为 0.90(p<0.001,95%CI:0.85-0.95)。

结论

尿液 8-oxo-Gsn 水平与虚弱独立相关。这种尿生物标志物可能是虚弱的一个有前途的指标。

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