Department of Physiology, University of the Basque Country, UPV/EHU, Leioa, Spain.
Department of Medicine, Bioaraba Research Institute, OSI Araba, Araba University Hospital, Vitoria-Gasteiz, Spain.
Eur J Clin Invest. 2021 Apr;51(4):e13420. doi: 10.1111/eci.13420. Epub 2020 Dec 1.
People with frailty and/or sarcopenia have an increased risk of negative health outcomes. However, their diagnosis is often difficult. Considering the potential value of myostatin and follistatin as biomarkers of these conditions, we aimed to compare the association between both myokines and frailty and/or sarcopenia in post-hospitalised older people. In addition, the capability of myostatin and follistatin for identifying frailty and sarcopenia was compared with physical tests.
Participants in this cross-sectional study consisted of 84 post-hospitalised patients immediately after discharge. Participants met the following inclusion criteria: aged ≥ 70 years, score of ≥20 on the Mini-Mental State Examination, and able to stand up and walk independently for at least 4 m. Serum myostatin and follistatin concentrations were measured by enzyme-linked immunosorbent assay. Body measures and results from 4 physical tests (hand grip, chair stand, 8-foot timed Up and Go (8TUG) and gait speed (GS)) were also recorded. Frailty was evaluated by the Fried index, and sarcopenia by the criteria of the European Working Group on Sarcopenia in Older People.
Myostatin concentration was lower and follistatin concentration higher in people with frailty or sarcopenia. Receiver operating characteristic curves indicated that GS and 8TUG tests had the greatest capability for identifying frailty. Myostatin was the only variable capable of identifying sarcopenia.
Myostatin may be a useful biomarker for sarcopenia in post-hospitalised older adults. However, it has a lower capability for identifying frailty than physical tests. Further studies using larger samples and these myokines together with other biomarkers are warranted.
衰弱和/或肌少症患者发生不良健康结局的风险增加。然而，其诊断往往较为困难。鉴于肌肉生长抑制素和激活素的潜在价值可作为这些疾病的生物标志物，我们旨在比较两者与衰弱和/或肌少症在出院后老年人中的相关性。此外，还比较了肌肉生长抑制素和激活素对识别衰弱和肌少症的能力与身体测试。
本横断面研究的参与者包括 84 名出院后立即出院的住院患者。参与者符合以下纳入标准：年龄≥70 岁，迷你精神状态检查评分≥20 分，能够独立站立并行走至少 4 米。通过酶联免疫吸附试验测量血清肌肉生长抑制素和激活素浓度。还记录了身体测量值和 4 项身体测试（握力、椅上站立、8 英尺计时起立行走（8TUG）和步态速度（GS））的结果。用 Fried 指数评估衰弱，用欧洲老年人肌少症工作组的标准评估肌少症。
衰弱或肌少症患者的肌肉生长抑制素浓度较低，激活素浓度较高。受试者工作特征曲线表明，GS 和 8TUG 测试对识别衰弱具有最大的能力。肌肉生长抑制素是唯一能够识别肌少症的变量。
肌肉生长抑制素可能是出院后老年衰弱患者有用的生物标志物。然而，其识别衰弱的能力低于身体测试。需要使用更大的样本和这些肌肽以及其他生物标志物进行进一步的研究。
