Kamper Rikke S, Nygaard Hanne, Praeger-Jahnsen Louis, Ekmann Anette, Ditlev Sisse Bolm, Schultz Martin, Hansen Sofie Krarup, Hansen Pernille, Pressel Eckart, Suetta Charlotte
Department of Geriatric & Palliative Medicine, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark.
CopenAge, Copenhagen Center for Clinical Age Research, University of Copenhagen, Copenhagen, Denmark.
J Cachexia Sarcopenia Muscle. 2024 Aug;15(4):1549-1557. doi: 10.1002/jcsm.13513. Epub 2024 Jun 18.
Growth differentiation factor-15 (GDF-15) has been associated with senescence, lower muscle strength, and physical performance in healthy older people. Still, it is not clear whether GDF-15 can be utilized as a biomarker of sarcopenia and frailty in the early stages of hospitalization. We investigated the association of plasma GDF-15 with sarcopenia and frailty in older, acutely admitted medical patients.
The present study is based on secondary analyses of cross-sectional data from the Copenhagen PROTECT study, a prospective cohort study including 1071 patients ≥65 years of age admitted to the acute medical ward at Copenhagen University Hospital, Bispebjerg, Denmark. Muscle strength was assessed using handgrip strength, and lean mass was assessed using direct segmental multifrequency bioelectrical impedance analyses and used to clarify the potential presence of sarcopenia defined according to guidelines from the European Working Group on Sarcopenia in Older People. Frailty was evaluated using the Clinical Frailty Scale. Plasma GDF-15 was measured using electrochemiluminescence assays from Meso Scale Discovery (MSD, Rockville, MD, USA).
We included 1036 patients with completed blood samples (mean age 78.9 ± 7.8 years, 53% female). The median concentration of GDF-15 was 2669.3 pg/mL. Systemic GDF-15 was significantly higher in patients with either sarcopenia (P < 0.01) or frailty (P < 0.001) compared with patients without the conditions. Optimum cut-off points of GDF-15 relating to sarcopenia and frailty were 1541 and 2166 pg/mL, respectively.
Systemic GDF-15 was higher in acutely admitted older medical patients with sarcopenia and frailty compared with patients without. The present study defined the optimum cut-off for GDF-15, related to the presence of sarcopenia and frailty, respectively. When elevated above the derived cutoffs, GDF-15 was strongly associated with frailty and sarcopenia in both crude and fully adjusted models.
生长分化因子15（GDF-15）与健康老年人的衰老、肌肉力量下降和身体机能有关。然而，尚不清楚GDF-15是否可作为住院早期肌少症和衰弱的生物标志物。我们调查了老年急性入院内科患者血浆GDF-15与肌少症和衰弱之间的关联。
本研究基于哥本哈根PROTECT研究的横断面数据进行二次分析，该前瞻性队列研究纳入了丹麦哥本哈根大学医院比斯佩比约格分院急性内科病房收治的1071例年龄≥65岁的患者。使用握力评估肌肉力量，使用直接节段多频生物电阻抗分析评估瘦体重，并根据老年人肌少症欧洲工作组的指南来明确是否存在肌少症。使用临床衰弱量表评估衰弱情况。采用美国马里兰州罗克维尔市Meso Scale Discovery公司（MSD）的电化学发光分析法检测血浆GDF-15。
我们纳入了1036例完成血样采集的患者（平均年龄78.9±7.8岁，53%为女性）。GDF-15的中位数浓度为2669.3 pg/mL。与无肌少症或衰弱的患者相比，患有肌少症（P<0.01）或衰弱（P<0.001）的患者全身GDF-15水平显著更高。与肌少症和衰弱相关的GDF-15最佳截断点分别为1541和2166 pg/mL。
与无肌少症和衰弱的患者相比，急性入院的老年内科肌少症和衰弱患者的全身GDF-15水平更高。本研究分别确定了与肌少症和衰弱相关的GDF-15最佳截断值。当高于推导的截断值时，在粗模型和完全调整模型中，GDF-15均与衰弱和肌少症密切相关。
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