The reverse metabolic syndrome in the elderly: Is it a “catabolic” syndrome?

Curcio, Francesco; Sasso, Giuseppe Lo; Liguori, Ilaria; Ferro, Gaetana; Russo, G.; Cellurale, Michele; Della-Morte, David; Testa, Gianluca; Cacciatore, Francesco; Bonaduce, Domenico; Abete, Pasquale

doi:10.1007/s40520-017-0815-7

Cited by 13 publications

(10 citation statements)

References 60 publications

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“…Reverse epidemiology or risk factor paradox has been mentioned in the case of body mass index, serum cholesterol, and blood pressure in elderly population (15, 16). However, there are limited outcome studies of acute-phase lipid in cerebrovascular and cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Lipid Paradox in Statin-Naïve Acute Ischemic Stroke But Not Hemorrhagic Stroke

et al. 2018

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Background: Low lipid level is associated with better cardiovascular outcome. However, lipid paradox indicating low lipid level having worse outcomes could be seen under acute injury in some diseases. The present study was designed to clarify the prognostic significance of acute-phase lipid levels within 1 day after admission for stroke on mortality in first-ever statin-naïve acute ischemic stroke (IS) and hemorrhagic stroke (HS).Methods: This observational study was conducted using the data collected from Stroke Registry In Chang-Gung Healthcare System (SRICHS) between 2009 and 2012. Patients with recurrent stroke, onset of symptoms >1 day, and history of the use of lipid-lowering agents prior to index stroke were excluded. Stroke was classified into IS and hypertension-related HS. The primary outcomes were 30-day and 1-year mortality identified by linkage to national death registry for date and cause of death. Receiver operating characteristic (ROC) curve analysis and multivariate Cox proportional hazard models were used to examine the association of lipid profiles on admission with mortality.Results: Among the 18,268 admitted stroke patients, 3,746 IS and 465 HS patients were eligible for analysis. In IS, total cholesterol (TC) <163.5 mg/dL, triglyceride (TG) <94.5 mg/dL, low-density lipoprotein (LDL) <100 mg/dL, non-high-density lipoprotein cholesterol (non-HDL-C) <130.5 mg/dL, and TC/HDL ratio <4.06 had significantly higher risk for 30-day/1-year mortality with hazard ratio (HR) of 2.05/1.37, 1.65/1.31, 1.68/1.38, 1.80/1.41, and 1.58/1.38, respectively, compared with high TC, TG, LDL, non-HDL-C, and TC/HDL ratio (p < 0.01 in all cases). In HS, lipid profiles were not associated with mortality, except HDL for 30-day mortality (p = 0.025) and high uric acid (UA) concentrations for 30-day and 1-year mortality (p = 0.002 and 0.012, respectively). High fasting glucose and high National Institute of Health Stroke Scale (NIHSS) score at admission were associated with higher 30-day and 1-year mortality in both IS and HS and low blood pressure only in IS (p < 0.05). Synergic effects on mortality were found when low lipids were incorporated with high fasting glucose, low blood pressure, and high NIHSS score in IS (p < 0.05).Conclusions: Lipid paradox showing low acute-phase lipid levels with high mortality could be seen in statin-naïve acute IS but not in HS. The mortality in IS was increased when low lipids were incorporated with high fasting glucose, low blood pressure, and high NIHSS score.

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Section: Introductionmentioning

confidence: 99%

Lipid Paradox in Statin-Naïve Acute Ischemic Stroke But Not Hemorrhagic Stroke

et al. 2018

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“…Obese and overweight colorectal cancer patients have shown lower mortality risks compared with underweight or normal patients when BMI has been evaluated after diagnosis [6]. This "obesity paradox" is like the "reverse metabolism" [7] and there is a U-shaped curved relationship between mortality and BMI in elderly patients [7].…”

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confidence: 99%

Letter to the editor regarding the article ‘Frailty and skeletal muscle in older adults with cancer’

Koçak

2020

Journal of Geriatric Oncology

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“…However, some traditional risk factors known to have a poor prognosis may vary in older adults and may contrast with expected effects. For example, in older adults, low BMI, low diastolic blood pressure and low cholesterol (which indicate reverse metabolic syndrome) have been shown to be significant predictors of mortality [42]. Future studies, such as prospective cohorts among older adults, are needed to confirm this result.…”

Section: Discussionmentioning

confidence: 99%

Predictors of three-month mortality among hospitalized older adults in Togo

et al. 2020

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Background Assessing hospital mortality and its predictors is important as some of these can be prevented through appropriate interventions. Few studies have reported hospital mortality data among older adults in sub-Saharan Africa. The objective of this study was to assess the mortality and associated factors among hospitalized older adults in Togo. Methods We conducted a prospective cohort study from February 2018 to September 2019 among patients ≥50 years admitted in medical and surgical services of six hospitals in Togo. Data were recorded during hospitalization and through telephone follow-up survey within 90 days after admission. The main outcome was all-cause mortality at 3 months. Survival curves were estimated using the Kaplan-Meier method and Cox regression analyses were performed to assess predictors of mortality. Results The median age of the 650 older adults included in the study period was 61 years, IQR: [55–70] and at least one comorbidity was identified in 59.7% of them. The all-cause mortality rate of 17.2% (95%CI: 14.4–20.4) and the majority of death (93.7%) occurred in hospital. Overall survival rate was 85.5 and 82.8% after 30 and 90 days of follow-up, respectively. Factors associated with 3-month mortality were the hospital level in the health pyramid, hospitalization service, length of stay, functional impairment, depression and malignant diseases. Conclusion Togolese health system needs to adjust its response to an aging population in order to provide the most effective care.

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The reverse metabolic syndrome in the elderly: Is it a “catabolic” syndrome?

Cited by 13 publications

References 60 publications

Lipid Paradox in Statin-Naïve Acute Ischemic Stroke But Not Hemorrhagic Stroke

Lipid Paradox in Statin-Naïve Acute Ischemic Stroke But Not Hemorrhagic Stroke

Letter to the editor regarding the article ‘Frailty and skeletal muscle in older adults with cancer’

Predictors of three-month mortality among hospitalized older adults in Togo

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