He Lingxiao, Yang Jinzhu, Lin Shujing, Shi Kanglin, Fang Ya
Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China.
Eur Geriatr Med. 2024 Oct;15(5):1347-1355. doi: 10.1007/s41999-024-01038-2. Epub 2024 Aug 27.
Frailty is a rising global health issue in ageing society. Easily accessible and sensitive tools are needed for frailty monitoring while routine blood factors can be potential candidates.
Data from 1907 participants (aged 60 years or above) were collected from the 4th to 9th wave of the English longitudinal study of ageing. 14 blood factors obtained from blood tests were included in the analysis. A 52-item frailty index (FI) was calculated for frailty evaluation. Logistic regression and Cox proportional hazards analysis were used to explore the relationships between baseline blood factors and the incidence of frailty over time respectively. All analyses were controlled for age and sex.
The mean age of participants was 67.3 years and 47.2% of them were male. Our study identified that 8 blood factors (mean corpuscular haemoglobin, HDL, triglyceride, ferritin, hsCRP, dehydroepiandrosterone, haemoglobin, and WBC) involved in inflammatory, nutritional and metabolic processes were associated with frailty. The combined model with these 8 blood factors had an AUC of 0.758 at cross-sectional level. In the Cox proportional hazards analysis, higher triglyceride (HR: 1.30, 95%CI: 1.07 ~ 1.59), WBC (HR: 1.16, 95%CI: 1.05 ~ 1.28), and lower HDL (HR: 0.58, 95%CI: 0.38 ~ 0.90) at baseline were linked to greater risk of developing frailty within 10 years. Compared to adults without abnormal blood factors at baseline, the hazard ratios of participants with two or more abnormal blood factors were almost twofold higher in developing frailty over time.
Routine blood factors, particularly triglyceride, HDL and WBC, could be used for frailty screening in clinical practice and estimate the development of frailty over time.
在老龄化社会中,衰弱是一个日益严重的全球健康问题。需要易于获取且敏感的工具来监测衰弱情况,而常规血液指标可能是潜在的候选指标。
从英国老龄化纵向研究的第4波至第9波中收集了1907名参与者(年龄60岁及以上)的数据。分析纳入了从血液检测中获得的14项血液指标。计算了一个包含52个条目的衰弱指数(FI)用于衰弱评估。分别使用逻辑回归和Cox比例风险分析来探讨基线血液指标与随时间衰弱发生率之间的关系。所有分析均对年龄和性别进行了控制。
参与者的平均年龄为67.3岁,其中47.2%为男性。我们的研究发现,参与炎症、营养和代谢过程的8项血液指标(平均红细胞血红蛋白、高密度脂蛋白、甘油三酯、铁蛋白、超敏C反应蛋白、脱氢表雄酮、血红蛋白和白细胞)与衰弱有关。在横断面水平上,这8项血液指标的联合模型的曲线下面积为0.758。在Cox比例风险分析中,基线时较高的甘油三酯(风险比:1.30,95%置信区间:1.07至1.59)、白细胞(风险比:1.16,95%置信区间:1.05至1.28)以及较低的高密度脂蛋白(风险比:0.58,95%置信区间:0.38至0.90)与10年内发生衰弱的风险增加有关。与基线时血液指标无异常的成年人相比,有两项或更多异常血液指标的参与者随时间发展为衰弱的风险比几乎高出两倍。
常规血液指标,特别是甘油三酯、高密度脂蛋白和白细胞,可用于临床实践中的衰弱筛查,并估计随时间衰弱的发展情况。