Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France; Geriatrics Department, CHU Lille, Lille, France.
Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167 - RID-AGE - Facteurs de risque et déterminants moléculaires des maladies liées au vieillissement, F-59000 Lille, France.
Exp Gerontol. 2020 Oct 1;139:111014. doi: 10.1016/j.exger.2020.111014. Epub 2020 Jun 26.
During aging, individuals can be classified as being in one of 3 different states: robust, frail or dependent. Frailty is described as reversible, so early detection offers the potential of returning the subject to a robust status. There are multiple clinical frailty scales but no gold standard and frailty is not systematically assessed in clinicians' daily practice. Reliable biomarkers of frailty are lacking, however, while their identification and systematic use would make this simple scale a useful clinical tool.
To conduct a review of the literature concerning the biomarkers associated with frailty and to compare in a meta-analysis the plasmatic values of each biomarker in the frail with the robust group.
503 articles were identified on PubMed, 467 on Scopus and 369 on Web Of Science. 67 articles were included, collecting a total of 32,934 robust subjects and 6864 frail subjects. C-reactive protein (CRP) (Standardized Mean Difference (SMD): 0.49 CI 95% [0.37-0.61]) was significantly higher in the frail group whereas hemoglobin (SMD: -0.67[-0.90; -0.44]), albumin (SMD: -0.62[-0.84; -0.41]), 25-hydroxyvitamin D (25OHD) (SMD: -0.43 [-0.64; -0.21]) and, in men, free testosterone (SMD: -0.77 [-1.05; -0.49]) were significantly lower in the frail group.
We found 5 biomarkers that were associated with frailty (CRP, hemoglobin, albumin, 25OHD and free testosterone in men) belonging to multiple physiological systems. Further cohort studies are needed to verify their ability to screen for frailty.
随着年龄的增长，个体可被分为以下三种状态之一：强健、衰弱或依赖。衰弱是可逆转的，因此早期发现为使衰弱者恢复强健状态提供了可能。目前有多种临床衰弱量表，但尚无金标准，且衰弱并未在临床医生的日常实践中得到系统评估。目前尚缺乏衰弱的可靠生物标志物，但如果能识别并系统使用这些标志物，那么这个简单的量表将成为一种有用的临床工具。
对与衰弱相关的生物标志物进行文献综述，并通过荟萃分析比较衰弱组与强健组之间每个生物标志物的血浆值。
在 PubMed 上共检索到 503 篇文献，在 Scopus 上共检索到 467 篇文献，在 Web Of Science 上共检索到 369 篇文献。共纳入 67 篇文献，共纳入 32934 名强健者和 6864 名衰弱者。在衰弱组中，C 反应蛋白（CRP）（标准化均数差（SMD）：0.49 CI 95% [0.37-0.61]）显著升高，而血红蛋白（SMD：-0.67[-0.90；-0.44]）、白蛋白（SMD：-0.62[-0.84；-0.41]）、25-羟维生素 D（25OHD）（SMD：-0.43 [-0.64；-0.21]）和男性游离睾酮（SMD：-0.77 [-1.05；-0.49]）显著降低。
我们发现了 5 种与衰弱相关的生物标志物（CRP、血红蛋白、白蛋白、25OHD 和男性游离睾酮），它们属于多个生理系统。还需要进一步的队列研究来验证它们筛查衰弱的能力。
