Department of Diabetes, Endocrinology and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan.
Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.
J Diabetes Investig. 2024 Nov;15(11):1675-1683. doi: 10.1111/jdi.14286. Epub 2024 Aug 14.
AIMS/INTRODUCTION: The clinical significance of age-related biomarkers in patients with diabetes has not been fully elucidated. In this study, we aimed to establish models to predict the progression of aging in patients with diabetes using biomarkers.
This single-center, retrospective cohort study included 115 Japanese patients with diabetes aged ≥60 years. Age-related adverse health outcomes were defined as emergency hospitalization, any increase in the level of nursing care certification, admission to a nursing home or death. The associations of age-related biomarker levels (adiponectin, growth differentiation factor 15 [GDF15], C-X-C motif chemokine ligand 9 and apelin) and clinical indicators with age-related adverse health outcomes were evaluated. Factors that predominantly influenced the occurrence of age-related adverse health outcomes were explored using the Cox proportional hazards model.
The mean age of the 115 participants was 73 years, 50.6% were men, the mean body mass index and hemoglobin A1c level were 25.3 kg/m and 9.79%, respectively. There were 26 age-related adverse health outcomes during the study period (median 1.93, range 0-4.65 years). In a model combining clinical indicators and biomarkers, including the Barthel Index, GDF15 and adiponectin, the occurrence of age-related adverse health outcomes was found to be significantly associated with GDF15 and Barthel Index. The group with both GDF15 and adiponectin levels higher than the median proved to be significantly higher than the group with both lower.
The measurement of GDF15 and adiponectin levels and the Barthel Index might be useful for predicting age-related adverse health outcomes in patients with diabetes.
目的/引言:年龄相关生物标志物在糖尿病患者中的临床意义尚未完全阐明。本研究旨在建立使用生物标志物预测糖尿病患者衰老进展的模型。
这是一项单中心、回顾性队列研究,纳入了 115 名年龄≥60 岁的日本糖尿病患者。与年龄相关的不良健康结局定义为急诊住院、护理水平认证任何程度的提高、入住疗养院或死亡。评估了与年龄相关的生物标志物水平(脂联素、生长分化因子 15[GDF15]、C-X-C 基序趋化因子配体 9 和 apelin)和临床指标与与年龄相关的不良健康结局的相关性。使用 Cox 比例风险模型探讨了对与年龄相关的不良健康结局发生有主要影响的因素。
115 名参与者的平均年龄为 73 岁,50.6%为男性,平均体重指数和血红蛋白 A1c 水平分别为 25.3kg/m2 和 9.79%。研究期间发生了 26 例与年龄相关的不良健康结局(中位数 1.93,范围 0-4.65 年)。在结合临床指标和生物标志物的模型中,包括 Barthel 指数、GDF15 和脂联素,与年龄相关的不良健康结局的发生与 GDF15 和 Barthel 指数显著相关。GDF15 和脂联素水平均高于中位数的组明显高于两者均低于中位数的组。
测量 GDF15 和脂联素水平以及 Barthel 指数可能有助于预测糖尿病患者与年龄相关的不良健康结局。