Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, Taipei, Taiwan.
Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan.
Front Public Health. 2022 Mar 10;10:847533. doi: 10.3389/fpubh.2022.847533. eCollection 2022.
Frailty is a commonly occurring geriatric condition that increases the risk of adverse health outcomes. The factors and predictors behind frailty are not yet well understood. A better understanding of these factors can enable prevention of frailty in elderly patients. The objective of this study was to determine the association between proteinuria and frailty in US individuals with metabolic syndrome (MetS). Data from the National Health and Nutrition Examination Survey III (NHANES III, 1988-1994) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. This is a cross-sectional study, and proteinuria and frailty were measured only once at enrollment. The study included 2,272 participants with MetS aged 40-90 years from the NHANES III. The participants underwent assessments to evaluate frailty and frailty components (low body weight, weakness, exhaustion, low physical activity, and slow walking). Proteinuria was represented as albumin-to-creatinine ratio (ACR) (mg/g) and divided into tertiles: T1-normal range (ACR <30 mg/g), T2-microalbuminuria (ACR 30-299 mg/g), and T3-macroalbuminuria (ACR ≥ 300 mg/g). We applied multiple logistic regression to determine the odds ratios (ORs) of frailty for T2 vs. T1 and T3 vs. T1 in both sexes. In the adjusted analysis for male participants, the ORs of frailty for T2 and T3 vs. T1 were 3.106 (95% confidence interval [CI] = 1.078-8.948, = 0.036) and 14.428 (95% CI = 4.231-49.193, < 0.001), respectively. For female participants, the ORs of frailty for T2 and T3 vs. T1 were 1.811 (95% CI = 1.071-3.063, = 0.027) and 2.926 (95% CI = 1.202-7.124, = 0.018), respectively. The positive association between T2 and T3 vs. T1, and frailty were statistically significant. The trends of higher likelihood of every frailty component were also statistically significant across increasing tertiles of proteinuria after multiple levels of adjustment for covariates ( < 0.05). Increased proteinuria levels were positively associated with frailty and each frailty component. Proteinuria might be a useful maker for frailty in individuals with MetS.
衰弱是一种常见的老年病，会增加不良健康后果的风险。衰弱的因素和预测因素尚不清楚。更好地了解这些因素可以预防老年患者的衰弱。本研究的目的是确定美国代谢综合征（MetS）患者蛋白尿与衰弱之间的关联。数据来自疾病控制与预防中心国家卫生与营养检查调查 III（NHANES III，1988-1994 年）国家中心的国家卫生统计中心。这是一项横断面研究，仅在入组时测量一次蛋白尿和衰弱。该研究包括来自 NHANES III 的 2272 名年龄在 40-90 岁之间患有 MetS 的参与者。参与者接受评估以评估虚弱和虚弱成分（低体重、虚弱、疲惫、低体力活动和缓慢行走）。蛋白尿表示为白蛋白与肌酐比值（ACR）（mg/g），并分为三分位：T1-正常范围（ACR <30mg/g）、T2-微量白蛋白尿（ACR 30-299mg/g）和 T3-大量白蛋白尿（ACR ≥ 300mg/g）。我们应用多变量逻辑回归来确定 T2 与 T1 和 T3 与 T1 相比，两性中衰弱的优势比（OR）。在男性参与者的调整分析中，T2 和 T3 与 T1 相比，衰弱的 OR 分别为 3.106（95%置信区间 [CI] = 1.078-8.948， = 0.036）和 14.428（95% CI = 4.231-49.193，<0.001）。对于女性参与者，T2 和 T3 与 T1 相比，衰弱的 OR 分别为 1.811（95% CI = 1.071-3.063， = 0.027）和 2.926（95% CI = 1.202-7.124， = 0.018）。T2 和 T3 与 T1 相比，以及衰弱与蛋白尿之间的正相关具有统计学意义。在对协变量进行多次调整后，随着蛋白尿三分位的升高，每个衰弱成分发生的可能性更高的趋势也具有统计学意义（<0.05）。蛋白尿水平升高与衰弱和每个衰弱成分呈正相关。蛋白尿可能是 MetS 个体衰弱的有用标志物。
