AAR  Vol.3 No.1 , February 2014
Relationship between bone mineral density, coronary risk factors, C-reactive protein, and Insulin growth factor in frail elderly
ABSTRACT

Objective: This study aimed to explore the relation between bone mineral density (BMD), inflammation, coronary risk factors, and Insulin growth factor (IGF) in frail elderly. Design: A casecontrol study. Setting: Ain Shams University Hospital Cairo, Egypt. Participants: Ninety aged 60 years and above; sixty frail (30 males and 30 females; mean age 70.03 ± 8.10) and thirty matched controls (15 males and 15 females; mean age 69.07 ± 5.93). Measurements: History, examination, comprehensive geriatric assessment, measurement of BMD, and laboratory investigations including; high sensitivity C-reactive protein (hs-CRP) glycated haemoglobin, IGF, lowdensity lipoprotein (LDL), high-density lipoprotein, total cholesterol, and triglycerides. Results: The frail group had significantly lower levels of triglycerides and LDL, hs-CRP and glycated haemoglobin levels were significantly higher (P < 0.001), and BMD and IGF levels were significantly lower when compared with the control group (P < 0.00*, P = 0.05) respectively. We also found that BMD had a significant positive linear correlation with IGF and negative correlation with age. Conclusion: Frailty was associated with low BMD, lower triglycerides & LDL levels, and higher hsCRP levels. A borderline significance was found between IGF levels and frailty. A positive correlation was found between BMD and IGF in frail.


Cite this paper
Amer, M. , Farid, T. , Farid, H. , Saber, H. and Mabrouk, R. (2014) Relationship between bone mineral density, coronary risk factors, C-reactive protein, and Insulin growth factor in frail elderly. Advances in Aging Research, 3, 43-47. doi: 10.4236/aar.2014.31008.
References
[1]   Fried, L., Walston, J. and Ferrucci, L. (2009) Frailty. In: Halter, J., Ouslander, J., Tinetti, M., et al., Eds., Hazzard’s Geriatric Medicine and Gerontology, 6th Edition, McGraw-Hill, New York, 631-646.

[2]   Topinková, E. (2008) Aging, disability and frailty. Getting older, facts about a biological process. Annals of Nutrition and Metabolism, 52, 6-11.

[3]   Salminen, H., Saaf, M., Johansson, S., Ringertz, H. and Strender, E. (2006) Nutritional status, as determined by the mini-nutritional assessment, and osteoporosis: A crosssectional study of an elderly female population. European Journal of Clinical Nutrition, 60, 486-493.
http://dx.doi.org/10.1038/sj.ejcn.1602341

[4]   Packard, P. and Heaney, R. (1997) Medical nutrition therapy for patients with osteoporosis. Journal of the American Dietetic Association, 97, 414-417.
http://dx.doi.org/10.1016/S0002-8223(97)00103-X

[5]   Vanitallie, T. (2003) Frailty in the elderly: Contributions of sarcopenia and visceral protein depletion. MetabolismClinical and Experimental, 52, 22-26.
http://dx.doi.org/10.1016/S0026-0495(03)00297-X

[6]   Afilalo, J. (2011) Frailty in patients with cardiovascular disease: Why, when, and how to measure. Current Cardiovascular Risk Reports, 5, 467-472.
http://dx.doi.org/10.1007/s12170-011-0186-0

[7]   Newman, A., Gottdiener, J., McBurnie, M., Hirsch, C., Kop, W., Tracy, R., et al. (2001) Associations of subclinical cardiovascular disease with frailty. Cardiovascular Health Study Research Group. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56, M158-M166.
http://dx.doi.org/10.1093/gerona/56.3.M158

[8]   Fried, L., Kronmal, R., Newman, A., Bild, D., Mittelmark, M., Polak, J., et al. (1998) Risk factors for 5 year mortality in older adults: The cardiovascular health study. The Journal of the American Medical Association, 279, 585592. http://dx.doi.org/10.1001/jama.279.8.585

[9]   Avila-Funes, J., Helmer, C., Amieva, H., Barberger-Gateau, P., Le Goff, M., Ritchie, K., et al. (2008) Frailty among community dwelling elderly people in France: The three city study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 63, 10891096.

[10]   Folstein, M., Folstein, S. and McHug, P. (1975) Minimental state. A practical method for gradient the cognitive state of patients for clinicians. Journal of Psychiatric Research, 12, 189-198.

[11]   El-Okl, M. (2002) Prevalence of Alzheimer dementia and other causes of dementia in Egyptian elderly. Dissertation, Ain Shams University, Cairo.

[12]   Katz, S., Ford, A., Moswowitz, R., Jackson, B. and Jaffe, M. (1963) Studies of illness in the aged. The index of ADL: Standardized measure of biological and psychological function. The Journal of the American Medical Association, 185, 914-919.

[13]   El-Sherpiny, M., Mortagy, A. and Fahy, H. (2000) Prevalence of hypercholesterolemia among elderly people living in nursing houses in Cairo. Geriatric Department Library, Ain Shams University, Cairo, 6.

[14]   Lawton, M. and Brody, E. (1969) Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179-86.
http://dx.doi.org/10.1093/geront/9.3_Part_1.179

[15]   Fillenbaum, G. (1986) The wellbeing of the elderly: Approaches to multi-dimensional assessment. World Health Organization, WHO Offset Publication No. 84, Arabic translation Distributed by the Eastern Mediterranean Regional Office.

[16]   Sheikh, J. and Yesavage, J. (1986) Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontology, 5, 165-173.

[17]   Shehta, A.S., El-Banouby, M.H., Mortagy, A.K., et al. (1998) Prevalence of depression among Egyptian geriatric community. Geriatric Department Library, Ain Shams University, Cairo, 3-5.

[18]   Orme, J., Reis, J. and Herz, E. (1986) Factorial and discriminate validity of the Center for Epidemiological Studies depression (CES-D) scale. Journal of Clinical Psychology, 42, 28-33.
http://dx.doi.org/10.1002/1097-4679(198601)42:1<28::AID-JCLP2270420104>3.0.CO;2-T

[19]   Kenny, A., Waynik, I., Smith, J., Fortinsky, R., Kleppinger, A. and McGee, D. (2006) Association between level of frailty and bone mineral density in communitydwelling men. Journal of Clinical Densitometry, 9, 309314. http://dx.doi.org/10.1016/j.jocd.2006.03.010

[20]   Elffors, L. (1998) Are osteoporotic fractures due to osteoporosis? Impacts of a frailty pandemic in an aging world. Aging (Milano), 10, 191-204.
http://dx.doi.org/10.1007/BF03339653

[21]   Walston, J., McBurnie, M., Newman, A., Tracy, R., Kop, W., Hirsch, C., et al. (2002) Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities, results from the cardiovascular health study. Archives of Internal Medicine, 162, 23332341. http://dx.doi.org/10.1001/archinte.162.20.2333

[22]   Hubbard, R., Searle, S., Mitnitski, A. and Rockwood, K. (2009) Effect of smoking on the accumulation of deficits, frailty and survival in older adults: A secondary analysis from the Canadian study of health and aging. The Journal of nutrition, Health & Aging, 13, 468-472.
http://dx.doi.org/10.1007/s12603-009-0085-y

[23]   Blaum, C., Xue, Q., Tian, J., Semba, R., Fried, L. and Walston, J. (2009) Is hyperglycemia associated with frailty status in older women? Journal of the American Geriatrics Society, 57, 840-847.
http://dx.doi.org/10.1111/j.1532-5415.2009.02196.x

[24]   Leng, S., Cappola, A., Andersen, R., Blackman, M., Koenig, K., Blair, M., et al. (2004) Serum levels of insulinlike growth factor-I (IGF-I) and dehydroepiandrosterone sulfate (DHEA-S), and their relationships with serum interleukin-6, in the geriatric syndrome of frailty. Aging Clinical and Experimental Research, 16, 153-157.
http://dx.doi.org/10.1007/BF03324545

[25]   Cappola, A., Xue, Q. and Fried, L. (2009) Multiple hormonal deficiencies in anabolic hormones are found in frail older women: The women’s health and aging studies. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 64, 243-248.
http://dx.doi.org/10.1093/gerona/gln026

[26]   Manuel Gomez, J. (2006) The role of insulin-like growth factor I components in the regulation of vitamin D. Current Pharmaceutical Biotechnology, 7, 125-132.
http://dx.doi.org/10.2174/138920106776597621

[27]   Giustina A, Mazziotti G & Canalis E. (2008) Growth hormone, insulin-like growth factors, and the skeleton. Endocrine Reviews, 29, 535-559.
http://dx.doi.org/10.1210/er.2007-0036

[28]   Van den Beld, A., Blum, W., Pols, H., Grobbee, D. and Lamberts, S. (2003) Serum insulin-like growth factor binding protein-2 levels as an indicator of functional ability in elderly men. European Journal of Endocrinology, 148, 627-634. http://dx.doi.org/10.1530/eje.0.1480627

 
 
Top