背景:人口老龄化可能会增加老年人营养不良的患病率,这增加了虚弱的风险。许多研究表明,骨骼肌细胞响应肌肉收缩而释放肌细胞,并可能与虚弱有关。这项研究旨在评估肌细胞素是否是老年营养不良患者虚弱的生物标志物。
方法:从基因表达综合和基因卡数据集中提取脆弱的生物标志物。在北京协和医院前瞻性纵向衰弱研究中,对55名年龄≥65岁的住院患者进行了相关的肌动蛋白和健康相关变量的评估。使用适当的试剂盒制备血清用于酶联免疫吸附测定。通过Spearman相关分析计算生物标志物与虚弱状态之间的相关性。进行多元线性回归以研究因素与虚弱评分之间的关联。
结果:体弱的患病率为13.21%。生物信息学分析表明,瘦素,腺苷5'-单磷酸活化蛋白激酶(AMPK),irisin,decorin,和肌肉生长抑制素是潜在的虚弱生物标志物。虚弱组的瘦素浓度明显较高,AMPK,和MSTN比稳健组(p<0.05)。AMPK与衰弱呈显著正相关(p<0.05)。衰弱前期和衰弱组的irisin浓度明显低于健壮组(p<0.05),而DCN浓度在各组之间没有差异。多元线性回归表明,影响相关系数的15个因素,前50%是ADL得分,MNA-SF得分,血清白蛋白浓度,排尿功能,听力功能,瘦素浓度,GDS-15得分,和MSTN浓度。
结论:促炎肌力因子,尤其是瘦素,肌肉生长抑制素,和AMPK,对老年人的肌肉质量和力量产生负面影响。ADL和营养状况在衰弱的发展中起着重要作用。我们的结果证实了虚弱的识别依赖于临床变量,Myokine浓度,和功能参数,这可能有助于识别和监测脆弱。
BACKGROUND: Population aging might increase the prevalence of undernutrition in older people, which increases the risk of frailty. Numerous studies have indicated that myokines are released by skeletal myocytes in response to muscular contractions and might be associated with frailty. This
study aimed to evaluate whether myokines are biomarkers of frailty in older inpatients with undernutrition.
METHODS: The frailty biomarkers were extracted from the Gene Expression Omnibus and Genecards datasets. Relevant myokines and health-related variables were assessed in 55 inpatients aged ≥ 65 years from the Peking Union Medical College Hospital prospective longitudinal frailty
study. Serum was prepared for enzyme-linked immunosorbent assay using the appropriate kits. Correlations between biomarkers and frailty status were calculated by Spearman\'s correlation analysis. Multiple linear regression was performed to investigate the association between factors and frailty scores.
RESULTS: The prevalence of frailty was 13.21%. The bioinformatics analysis indicated that leptin, adenosine 5\'-monophosphate-activated protein kinase (AMPK), irisin, decorin, and
myostatin were potential biomarkers of frailty. The frailty group had significantly higher concentrations of leptin, AMPK, and MSTN than the robust group (p < 0.05). AMPK was significantly positively correlated with frailty (p < 0.05). The pre-frailty and frailty groups had significantly lower concentrations of irisin than the robust group (p < 0.05), whereas the DCN concentration did not differ among the groups. Multiple linear regression suggested that the 15 factors influencing the coefficients of association, the top 50% were the ADL score, MNA-SF score, serum albumin concentration, urination function, hearing function, leptin concentration, GDS-15 score, and MSTN concentration.
CONCLUSIONS: Proinflammatory myokines, particularly leptin,
myostatin, and AMPK, negatively affect muscle mass and strength in older adults. ADL and nutritional status play major roles in the development of frailty. Our results confirm that identification of frailty relies upon clinical variables, myokine concentrations, and functional parameters, which might enable the identification and monitoring of frailty.