Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Am J Cardiol. 2022 Mar 1;166:65-71. doi: 10.1016/j.amjcard.2021.11.018. Epub 2021 Dec 30.
Frailty commonly coexists with heart failure and although both have been associated with neurohormonal dysregulation, inflammation, catabolism, and skeletal muscle dysfunction, there are still no defined biomarkers to assess frailty, especially from the perspective of populations with cardiovascular diseases. This is a cross-sectional study with 106 outpatients with heart failure, aged ≥60 years, which aimed to assess frailty through a physical (frailty phenotype) and multidimensional (Tilburg Frailty Indicator) approach and to analyze its association with inflammatory and humoral biomarkers (high sensitivity C-reactive protein [hs-CRP], interleukin 6, tumor necrosis factor-α, insulin-like growth factor-1, and total testosterone), clinical characteristics, and functional capacity. In univariate analysis, hs-CRP was associated with frailty in both phenotype and Tilburg Frailty Indicator assessment (PR = 1.005, 95% confidence interval [CI] 1.001 to 1.009, p = 0.027 and PR = 1.015, 95% CI 1.006 to 1.024, p = 0.001, respectively), which remained significant in the final multivariate model in the frailty assessment by the phenotype (PR = 1.004, 95% CI 1.001 to 1.008, p = 0.025). There was no statistically significant difference between the groups for other biomarkers analyzed. Frailty was also associated with worse functional capacity, nonoptimized pharmacological treatment and a greater number of drugs in use, age, female gender, and a greater number of comorbidities. In conclusion, frailty is associated with higher levels of hs-CRP, which can indicate it is a promising frailty biomarker.
衰弱通常与心力衰竭并存，尽管两者都与神经激素失调、炎症、分解代谢和骨骼肌功能障碍有关，但目前仍没有确定的生物标志物来评估衰弱，特别是从心血管疾病患者的角度来看。这是一项横断面研究，纳入了 106 名年龄≥60 岁的心力衰竭门诊患者，旨在通过身体（衰弱表型）和多维（蒂尔堡衰弱指标）方法评估衰弱，并分析其与炎症和体液生物标志物（高敏 C 反应蛋白 [hs-CRP]、白细胞介素 6、肿瘤坏死因子-α、胰岛素样生长因子-1 和总睾酮）、临床特征和功能能力的关系。在单因素分析中，hs-CRP 与表型和 Tilburg 衰弱指标评估的衰弱相关（PR=1.005，95%置信区间 [CI] 1.001 至 1.009，p=0.027 和 PR=1.015，95%CI 1.006 至 1.024，p=0.001），在表型衰弱评估的最终多变量模型中仍具有显著性（PR=1.004，95%CI 1.001 至 1.008，p=0.025）。在分析的其他生物标志物方面，两组之间没有统计学上的显著差异。衰弱还与较差的功能能力、非优化的药物治疗和使用更多的药物、年龄、女性和更多的合并症相关。总之，衰弱与更高水平的 hs-CRP 相关，这表明它是一种有前途的衰弱生物标志物。
