与衰弱相关的血清生物标志物可预测老年髋部骨折患者的不良结局。
Serum biomarkers related to frailty predict negative outcomes in older adults with hip fracture.
作者信息
Cedeno-Veloz B, Lozano-Vicario L, Rodríguez-García A, Zambom-Ferraresi F, Galbete A, Fernández-Irigoyen J, Santamaría E, García-Hermoso A, Calvani R, Ramírez-Vélez R, Izquierdo M, Martínez-Velilla N
机构信息
Geriatric Department, Navarre University Hospital (HUN), Irunlarrea 3, 31008, Pamplona, Navarra, Spain.
Navarrabiomed-Institute for Health Research of Navarra (IDISNA), Irunlarrea 3, 31008, Pamplona, Navarra, Spain.
出版信息
J Endocrinol Invest. 2024 Mar;47(3):729-738. doi: 10.1007/s40618-023-02181-6. Epub 2023 Aug 21.
PURPOSE
Hip fracture is a public health problem worldwide. Traditional prognostic models do not include blood biomarkers, such as those obtained by proteomics. This study aimed to investigate the relationships between serum inflammatory biomarkers and frailty in older adults with hip fracture as well as adverse outcomes at one and three months after discharge.
METHODS
A total of 45 patients aged 75 or older who were admitted for hip fracture were recruited. At admission, a Comprehensive Geriatric Assessment (CGA) was conducted, which included a frailty assessment using the Clinical Frailty Scale (CFS). Blood samples were collected before surgery. Participants were followed up at one and three months after discharge. The levels of 45 cytokines were analyzed using a high-throughput proteomic approach. Binary logistic regression was used to determine independent associations with outcomes, such as functional recovery, polypharmacy, hospital readmission, and mortality.
RESULTS
The results showed that IL-7 (OR 0.66 95% CI 0.46-0.94, p = 0.022) and CXCL-12 (OR 0.97 95% CI 0.95-0.99, p = 0.011) were associated with better functional recovery at three months after discharge, while CXCL-8 (OR 1.07 95% CI 1.01-1.14, p = 0.019) was associated with an increased risk of readmission.
CONCLUSIONS
These findings suggest that immunology biomarkers may represent useful predictors of clinical outcomes in hip fracture patients.
目的
髋部骨折是一个全球性的公共卫生问题。传统的预后模型未纳入血液生物标志物，如通过蛋白质组学获得的生物标志物。本研究旨在调查老年髋部骨折患者血清炎症生物标志物与衰弱之间的关系，以及出院后1个月和3个月时的不良结局。
方法
共招募了45名年龄在75岁及以上因髋部骨折入院的患者。入院时进行了综合老年评估（CGA），其中包括使用临床衰弱量表（CFS）进行衰弱评估。在手术前采集血样。对参与者在出院后1个月和3个月进行随访。使用高通量蛋白质组学方法分析45种细胞因子的水平。采用二元逻辑回归确定与功能恢复、多重用药、再次入院和死亡率等结局的独立关联。
结果
结果显示，白细胞介素-7（IL-7）（比值比[OR]0.66，95%置信区间[CI]0.46 - 0.94，p = 0.022）和CXC趋化因子配体12（CXCL-12）（OR 0.97，95%CI 0.95 - 0.99，p = 0.011）与出院后3个月更好的功能恢复相关，而CXC趋化因子配体8（CXCL-8）（OR 1.07，95%CI 1.01 - 1.14，p = 0.019）与再次入院风险增加相关。
结论
这些发现表明，免疫生物标志物可能是髋部骨折患者临床结局的有用预测指标。
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