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Kupisz-Urbanska M, Marcinowska-Suchowierska E, Jankowski P. Association between Blood Parameters of Nutritional Status and Functional Status in Extreme Longevity. Nutrients 2024; 16:1141. [PMID: 38674833 PMCID: PMC11054152 DOI: 10.3390/nu16081141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The relationship between functional and nutritional status in the geriatric population remains an issue of debate and there is a gap in the knowledge regarding this field in long-lived individuals. AIM The main aim of this study was to assess the association between selected blood parameters of nutritional status and functional status in extreme longevity. METHODS The inclusion criteria were centenarians above 100 years of age who were examined at their homes, and blood samples were collected. The study group consisted of 170 individuals (25 men and 145 women, median age 100.75 years [100.29-101.58]). RESULTS Total protein and albumin serum concentration was significantly lower in long-lived individuals with severe functional decline compared to individuals with preserved functional status, p = 0.000001 and p = 0.0000, respectively. Iron serum level was significantly higher in the group with preserved functional status, p = 0.04. Preserved functional status was positively correlated with total protein serum concentration (p = 0.000), albumin concentration (p = 0.000), and iron serum level (p = 0.029). A negative correlation was stated between c-reactive protein (CRP) and functional status (p = 0.032). Univariable logistic regression analysis showed that the functional status of long-lived individuals depends on total protein (OR 2.89, CI 95% [1.67-5.0]) and albumin concentrations (OR 2.34, CI 95% [1.39-3.92]). Multivariable backward stepwise logistic regression analysis showed that a total protein concentration was the only variable independently related to the preserved functional status (OR 3.2, 95% Cl [1.8-5.67]). CONCLUSIONS In long-lived individuals, the total serum protein and albumin levels are lower in centenarians with severe functional decline, and they correlate with functional status. Total protein serum concentration is the only factor independently related to the preserved functional status in extreme longevity.
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Affiliation(s)
- Malgorzata Kupisz-Urbanska
- Department of Geriatrics, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland; (E.M.-S.); (P.J.)
| | - Ewa Marcinowska-Suchowierska
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland; (E.M.-S.); (P.J.)
- Department of Geriatrics and Gerontology, School of Public Health, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland
| | - Piotr Jankowski
- Department of Internal Medicine and Geriatric Cardiology, Medical Centre of Postgraduate Education, 01-813 Warsaw, Poland; (E.M.-S.); (P.J.)
- Department of Epidemiology and Health Promotion, School of Public Health, Centre of Postgraduate Medical Education, 01-813 Warsaw, Poland
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Reaven NL, Funk SE, Mathur V, Ferguson TW, Lai J, Tangri N. Association of the Kidney Failure Risk Equation With High Health Care Costs. Kidney Int Rep 2023. [DOI: 10.1016/j.ekir.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
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Chang J, Hou WW, Wang YF, Sun QM. Main Risk Factors Related to Activities of Daily Living in Non-Dialysis Patients with Chronic Kidney Disease Stage 3-5: A Case-Control Study. Clin Interv Aging 2020; 15:609-618. [PMID: 32431494 PMCID: PMC7200239 DOI: 10.2147/cia.s249137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/11/2020] [Indexed: 02/06/2023] Open
Abstract
Introduction Elderly people are at increased risk of falls, disability and death due to reduced functional reserve, decline in multiple systems functions, which affects their activities of daily living (ADL) and eventually develop into frailty. The ADL assessment is conducive to early detection to avoid further serious situations. Previous studies on patients’ activities of daily living with chronic kidney disease (CKD) are mainly focused on dialysis patients. Little information is available on non-dialysis patients. Patients and Methods A total of 303 elderly patients with CKD stage 3–5 who were admitted to our hospital were selected. ADL evaluation was performed on patients at admission, with Barthel index (BI) as the evaluation tool. They were divided into two groups based on BI (≥60 and <60). Demographic information, lifestyle and clinical profile were collected. The risk factors related to ADL were analyzed by univariate and multivariate models. Results The data of 303 patients enrolled in this study were analyzed. The average age of patients was 84.48± 7.14 years and 62.05% were male. There were 88 patients (29.04%) in BI <60 group and 215 patients (70.96%) in the BI ≥60 group. The average age of subjects in the two groups was 87.47 ± 5.85 years and 83.26± 7.28 years, respectively. On univariate analysis, ADL impairment was associated with many factors, such as age, body mass index, blood lipid, heart rate, smoking history, Charlson comorbidity index (CCI), hemoglobin, serum albumin, BNP, eGFR, etc. Multivariate logistic regression showed that age (OR 1.08, 95% CI 1.00–1.17, P=0.0390), Charlson comorbidity index (OR 4.75, 95% CI 1.17–19.30, P=0.0295), and serum albumin (OR 0.80, 95% CI 0.70–0.92, P=0.0012) were the independent risk factors of ADL impairment. Conclusion Decline of ADL in CKD patients was independently correlated with age, Charlson comorbidity index and serum albumin. ADL and its influential factors in the elderly CKD patients deserve further attention.
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Affiliation(s)
- Jing Chang
- Department of Internal Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Wen-Wen Hou
- Department of Internal Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yan-Fei Wang
- Department of Internal Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Qian-Mei Sun
- Department of Internal Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People's Republic of China
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Barin FR, Durigan JLQ, Oliveira KDS, Migliolo L, Almeida JA, Carvalho M, Petriz B, Selistre-de-Araujo HS, Fontes W, Franco OL, Marqueti RDC. Beneficial effects of resistance training on the protein profile of the calcaneal tendon during aging. Exp Gerontol 2017; 100:54-62. [DOI: 10.1016/j.exger.2017.10.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 09/23/2017] [Accepted: 10/20/2017] [Indexed: 01/08/2023]
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Bukhari SSI, Phillips BE, Wilkinson DJ, Limb MC, Rankin D, Mitchell WK, Kobayashi H, Greenhaff PL, Smith K, Atherton PJ. Intake of low-dose leucine-rich essential amino acids stimulates muscle anabolism equivalently to bolus whey protein in older women at rest and after exercise. Am J Physiol Endocrinol Metab 2015; 308:E1056-65. [PMID: 25827594 DOI: 10.1152/ajpendo.00481.2014] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/26/2015] [Indexed: 11/22/2022]
Abstract
Dysregulated anabolic responses to nutrition/exercise may contribute to sarcopenia; however, these characteristics are poorly defined in female populations. We determined the effects of two feeding regimes in older women (66 ± 2.5 yr; n = 8/group): bolus whey protein (WP-20 g) or novel low-dose leucine-enriched essential amino acids (EAA) [LEAA; 3 g (40% leucine)]. Using [(13)C6]phenylalanine infusions, we quantified muscle (MPS) and albumin (APS) protein synthesis at baseline and in response to both feeding (FED) and feeding plus exercise (FED-EX; 6 × 8 knee extensions at 75% 1-repetition maximum). We also quantified plasma insulin/AA concentrations, whole leg (LBF)/muscle microvascular blood flow (MBF), and muscle anabolic signaling by phosphoimmunoblotting. Plasma insulinemia and EAA/aemia were markedly greater after WP than LEAA (P < 0.001). Neither LEAA nor WP modified LBF in response to FED or FED-EX, whereas MBF increased to a similar extent in both groups only after FED-EX (P < 0.05). In response to FED, both WP and LEAA equally stimulated MPS 0-2 h (P < 0.05), abating thereafter (0-4 h, P > 0.05). In contrast, after FED-EX, MPS increased at 0-2 h and remained elevated at 0-4 h (P < 0.05) with both WP and LEAA. No anabolic signals quantifiably increased after FED, but p70 S6K1 Thr(389) increased after FED-EX (2 h, P < 0.05). APS increased similarly after WP and LEAA. Older women remain subtly responsive to nutrition ± exercise. Intriguingly though, bolus WP offers no trophic advantage over LEAA.
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Affiliation(s)
- Syed S I Bukhari
- Medical Research Council/Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, United Kingdom; and
| | - Bethan E Phillips
- Medical Research Council/Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, United Kingdom; and
| | - Daniel J Wilkinson
- Medical Research Council/Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, United Kingdom; and
| | - Marie C Limb
- Medical Research Council/Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, United Kingdom; and
| | - Debbie Rankin
- Medical Research Council/Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, United Kingdom; and
| | - William K Mitchell
- Medical Research Council/Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, United Kingdom; and
| | | | - Paul L Greenhaff
- Medical Research Council/Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, United Kingdom; and
| | - Kenneth Smith
- Medical Research Council/Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, United Kingdom; and
| | - Philip J Atherton
- Medical Research Council/Arthritis Research United Kingdom Centre of Excellence for Musculoskeletal Ageing Research, University of Nottingham, Derby, United Kingdom; and
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Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marín-Ciancas F, Malafarina V. Serum albumin and health in older people: Review and meta analysis. Maturitas 2015; 81:17-27. [PMID: 25782627 DOI: 10.1016/j.maturitas.2015.02.009] [Citation(s) in RCA: 282] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 02/20/2015] [Accepted: 02/21/2015] [Indexed: 12/23/2022]
Abstract
Albumin is the most abundant plasmatic protein. It is only produced by the liver and the full extent of its metabolic functions is not known in detail. One of the main roles assigned to albumin is as an indicator of malnutrition. There are many factors, in addition to nutrition, that influence levels of albumin in plasma. The main aim of this review is to assess the clinical significance of albumin in elderly people in the community, in hospital and in care homes. Following the review, it can be stated that age is not a cause of hypoalbuminemia. Albumin is a good marker of nutritional status in clinically stable people. Significant loss of muscle mass has been observed in elderly people with low albumin levels. Hypoalbuminemia is a mortality prognostic factor in elderly people, whether they live in the community or they are in hospital or institutionalized. Low levels of albumin are associated to worse recovery following acute pathologies. Inflammatory state and, particularly, high concentrations of IL-6 and TNF-alpha, are two of the main influencing factors of hypoalbuminemia. In elderly patients with a hip fracture, albumin levels below 38 g/L are associated to a higher risk of post-surgery complications, especially infections. Further research is needed on the impact of nutritional intervention upon albumin levels and on the outcomes in elderly people in the community, in hospital and in care.
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Affiliation(s)
- Sonia Cabrerizo
- Nutrition Service, Clinica Los Manzanos, Grupo Viamed, Calle Hermanos Maristas, 26140 Lardero, Spain
| | - Daniel Cuadras
- Servei d'Assessorament Metodològic i Estadístic a la RecercaUnitat de Recerca i Desenvolupament, Parc Sanitari Sant Joan de Déu - Fundació Sant Joan de Déu, Dr. Antoni Pujades 42, 08830 Sant Boi de Llobregat (Barcelona), Spain
| | - Fernando Gomez-Busto
- Geriatric Department, Residencia San Prudencia, Calle Francia 35, 01002 Vitoria-Gasteiz, Spain
| | - Iñaki Artaza-Artabe
- Geriatric Department, Orue Centro Socio Sanitario, Grupo Igurco, B° San Miguel Dudea s/n, 48340 Amorebieta, Spain
| | - Fernando Marín-Ciancas
- Geriatric Department, Clinica Los Manzanos, Grupo Viamed, Calle Hermanos Maristas, 26140 Lardero, Spain
| | - Vincenzo Malafarina
- Geriatric Department, Clinica Los Manzanos, Grupo Viamed, Calle Hermanos Maristas, 26140 Lardero, Spain.
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Hausman DB, Fischer JG, Johnson MA. Protein, lipid, and hematological biomarkers in centenarians: Definitions, interpretation and relationships with health. Maturitas 2012; 71:205-12. [DOI: 10.1016/j.maturitas.2011.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2011] [Accepted: 12/03/2011] [Indexed: 12/29/2022]
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Abstract
This report reviews decade two of the lifetime diet restriction study of the dog. Labrador retrievers (n 48) were paired at age 6 weeks by sex and weight within each of seven litters, and assigned randomly within the pair to control-feeding (CF) or 25 % diet restriction (DR). Feeding began at age 8 weeks. The same diet was fed to all dogs; only the quantity differed. Major lifetime observations included 1.8 years longer median lifespan among diet-restricted dogs, with delayed onset of late life diseases, especially osteoarthritis. Long-term DR did not negatively affect skeletal maturation, structure or metabolism. Among all dogs, high static fat mass and declining lean body mass predicted death, most strongly at 1 year prior. Fat mass above 25 % was associated with increasing insulin resistance, which independently predicted lifespan and chronic diseases. Metabolizable energy requirement/lean body mass most accurately explained energy metabolism due to diet restriction; diet-restricted dogs required 17 % less energy to maintain each lean kilogram. Metabonomics-based urine metabolite trajectories reflected DR-related differences, suggesting that signals from gut microbiota may be involved in the DR longevity and health responses. Independent of feeding group, increased hazard of earlier death was associated with lower lymphoproliferative responses to phytohaemagglutinin, concanavalin A, and pokeweed mitogen; lower total lymphocytes, T-cells, CD4 and CD8 cells; lower CD8 percentages and higher B-cell percentages. When diet group was taken into account, PWM responses and cell counts and percentages remained predictive of earlier death.
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Gom I, Fukushima H, Shiraki M, Miwa Y, Ando T, Takai K, Moriwaki H. Relationship between serum albumin level and aging in community-dwelling self-supported elderly population. J Nutr Sci Vitaminol (Tokyo) 2007; 53:37-42. [PMID: 17484377 DOI: 10.3177/jnsv.53.37] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
While lower serum albumin concentration is often found in the elderly, a relation between serum albumin and age has not been fully elucidated. We conducted population-based cross-sectional and 5-y longitudinal study to examine the relation. A total of 22,705 male and 40,149 female, aged 65 y and older, living in Gifu, participated in the health check service conducted by Gifu City Medical Association. They were self-supported in the activity of daily living and 3,438 of them were followed up every year from 1999 to 2003. Serum albumin levels decreased with age in both men and women. In the cross-sectional study, median value declined from 4.3 g/dL in males aged 65-69 y to 3.9 g/dL in 90< or = y, and 4.3 g/dL to 4.0 g/dL in females. Incidence of hypoalbuminemia (serum albumin < or =3.5 g/dL) increased in parallel with age from 1.2% (65-69 y) to 6.6% (85-89) in males, and 0.6% to 4.1% in females. In the longitudinal study, regression analysis showed a significant decline in serum albumin of 0.015 g/dL per year (r= -0.716) in males, and 0.012 g/ dL per year (r= -0.794) in females. Relative reduction of serum albumin in 5 y was larger in advanced age; 1.2% in females aged 65-69 y and 3.1% in 85-89 y (p<0.05), but not in males. In conclusion, a fall in serum albumin concentration in community-dwelling, self-supported elderly persons was associated significantly with aging.
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Affiliation(s)
- Ikuko Gom
- Department of Gastroenterology, Gifu University Graduate School of Medicine, Gifu 501-1194, Japan
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Thalacker-Mercer AE, Johnson CA, Yarasheski KE, Carnell NS, Campbell WW. Nutrient ingestion, protein intake, and sex, but not age, affect the albumin synthesis rate in humans. J Nutr 2007; 137:1734-40. [PMID: 17585023 PMCID: PMC3885871 DOI: 10.1093/jn/137.7.1734] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The aim of this study was to assess the effects of nutrient ingestion, dietary protein intake, age, and sex on the fractional synthesis rate (FSR) of albumin. Thirty-six healthy free-living individuals (8 females and 10 males aged 21-43 y and 9 females and 9 males aged 63-79 y) completed three 18-d periods of controlled feeding with protein intakes of 125% (P125, 1.00 g protein x kg(-1) x d(-1)), 94% (P94, 0.75 g protein x kg(-1) x d(-1)), and 63% (P63, 0.50 g protein x kg(-1) x d(-1)) of the recommended dietary allowance. On d 12 of each trial, postabsorptive (PA) serum albumin concentration was determined and PA and postprandial (PP) albumin FSR were estimated from the rate of l-[1- 13C] leucine incorporation into plasma albumin during an 8-h infusion. There were no age-related differences in PA and PP albumin FSR. Albumin FSR was higher PP than PA (P < 0.0001), and the increase in albumin FSR from PA to PP was smaller as dietary protein intake decreased from P125 to P94 and P63 (P < 0.05). Independent of protein intake, males had a higher albumin FSR (P < 0.05) and a greater increase in albumin FSR with feeding (P < 0.05). There was no age or dietary protein effect on serum albumin concentrations, but males had higher albumin concentrations than females (P < 0.0001). These results show that older persons are responsive to nutrient ingestion and dietary protein-related changes in albumin FSR. The greater albumin synthesis rate in males might contribute to a higher albumin concentration set point.
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Affiliation(s)
| | - Craig A. Johnson
- Department of Mathematics, Brigham Young University-Idaho, Rexburg, ID 83460
| | | | - Nadine S. Carnell
- Department of Foods and Nutrition, Purdue University, West Lafayette, IN 47906
| | - Wayne W. Campbell
- Department of Foods and Nutrition, Purdue University, West Lafayette, IN 47906
- To whom correspondence should be addressed.
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Huber KR, Mostafaie N, Stangl G, Worofka B, Kittl E, Hofmann J, Hejtman M, Michael R, Weissgram S, Leitha T, Jungwirth S, Fischer P, Tragl KH, Bauer K. Clinical chemistry reference values for 75-year-old apparently healthy persons. Clin Chem Lab Med 2006; 44:1355-60. [PMID: 17087648 DOI: 10.1515/cclm.2006.247] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractClin Chem Lab Med 2006;44:1355–60.
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