Association between low-grade albuminuria and frailty among community-dwelling middle-aged and older people: a cross-sectional analysis from I-Lan Longitudinal Aging Study

Chang, Chun Chin; Hsu, Chien Yi; Chang, Tsan‐Kuo; Huang, Po Hsun; Liu, Li Kuo; Chen, Liang Kung; Chen, Jaw Wen; Lin, Shing Jong

doi:10.1038/srep39434

Cited by 22 publications

(17 citation statements)

References 29 publications

(35 reference statements)

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“…In this study, elevated ACR was negatively associated with physical function. Similarly, elevated ACR doubles the risk of disability [30] and is related to increased frailty [31]. We also observed that this association was robust to adjustment for CVD and measures of cardiac and macrovascular functions suggesting that independent microvascular mechanisms may be involved.…”

Section: Cardiovascular Contribution To Pfssupporting

confidence: 57%

Sex differences in the contribution of different physiological systems to physical function in older adults

et al. 2021

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Having the physical function to undertake activities of daily living (ADLs) is essential in order to maintain independence. The aim of this study is to investigate factors associated with physical function in older adults and determine if these associations differ in men versus women. In total, 726 participants (57% men; 73±7 years old) from a population-based cohort, the Southall and Brent Revisited (SABRE) study, completed questionnaires permitting a physical function score (PFS) to be calculated. Detailed phenotyping was performed including cardiovascular (echocardiography and macrovascular and microvascular functions), skeletal muscle (grip strength and oxidative capacity) and lung (pulmonary) function measurements. In a sub-group, maximal aerobic capacity was estimated from a sub-maximal exercise test. In women versus men, the association between grip strength and PFS was nearly 3 times stronger, and the association between microvascular dysfunction and PFS was over 5 times stronger (standardized β-coefficient (95% CI) 0.34 (0.22, 0.45) versus 0.11 (0.01,0.22) and −0.27 (−0.37, −0.17) versus −0.05 (−0.14, 0.04), respectively). In men, the association between cardiorespiratory fitness and PFS was 3 times greater than that in women (standardized β-coefficient (95% CI) 0.33 (0.22, 0.45) versus 0.10 (−0.04, 0.25). Cardiovascular, skeletal muscle and pulmonary factors all contribute to self-reported physical function, but the relative pattern of contribution differs by sex. Grip strength and microvascular function are most strongly associated with physical function in women while cardiorespiratory fitness is most strongly associated with physical function in men. This is relevant to the design of effective interventions that target maintenance of physical function in old age.

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Section: Cardiovascular Contribution To Pfssupporting

confidence: 57%

Sex differences in the contribution of different physiological systems to physical function in older adults

et al. 2021

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“…We assumed that incident LTC in the present study was caused by not only physical impairment but also cognitive dysfunction [ 19 ]. Several previous studies have suggested that an elevated UACR is reflected by generalized vascular endothelial dysfunction and microvascular diseases [ 14 – 16 , 18 , 20 , 21 ]. In the brain, microvascular diseases can increase the permeability of the blood-brain barrier, which leads to extravasation of blood substances and leakage of serum proteins [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

The urine albumin-creatinine ratio is a predictor for incident long-term care in a general population

et al. 2018

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BackgroundSeveral types of cardiovascular diseases (CVDs) impair the physical and mental status. The purpose of this study was to assess the predictive ability of several cardiovascular biomarkers for identifying the incidence of disability as future recipients of public long-term care (LTC) service.MethodsThe subjects of this study were community-dwelling elderly individuals ≥ 65 years of age without a history of CVD (n = 5,755; mean age, 71 years). The endpoint of this study was official certification as a recipient of LTC. The cohort was divided into quartiles (Qs) based on the levels of three CVD biomarkers: the urinary albumin-creatinine ratio (UACR), plasma B-type natriuretic peptide concentration (BNP), and serum high-sensitivity C-reactive protein concentration (hsCRP). A time-dependent Cox proportional hazard model was used to determine the multi-adjusted relative hazard ratios (HRs) for incident LTC among the quartiles of each biomarker.ResultsDuring the follow-up (mean 5.6 years), 710 subjects were authorized as recipients of LTC. The HR was only significantly increased in the higher Qs of UACR (Q3, p < 0.01; Q4, p < 0.001). However, other biomarkers were not significantly associated with the endpoint. The risk predictive performance for the incidence of LTC as evaluated by an essential model (i.e. age- and sex-adjusted) was significantly improved by incorporating the UACR (net reclassification improvement = 0.084, p < 0.01; integrated discrimination improvement = 0.0018, p < 0.01).ConclusionsThese results suggest that an increased UACR is useful for predicting physical and cognitive dysfunction in an elderly general population.

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“…The whole-blood HbA1c concentration was measured using an enzymatic method with a high-performance liquid chromatography analyzer (G8; Tosoh Bioscience, Inc., San Francisco, CA, USA). A single voided morning urine sample was used to measure the urinary albumin-to-creatinine ratio 40 . Activin A and follistatin concentrations were measured by ELISA (Quantikine human immunoassays; R&D Systems, Minneapolis, MN, USA).…”

Section: Methodsmentioning

confidence: 99%

Increased activin A levels in prediabetes and association with carotid intima-media thickness: a cross-sectional analysis from I-Lan Longitudinal Aging Study

Kuo

Hsu

et al. 2018

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Activin A and its binding protein follistatin may be crucial in glucose homeostasis, as multifunctional proteins mediating inflammatory and anti-inflammatory effects. However, clinical data on the activin A level in prediabetes, and the association between the circulating activin A level and carotid intima-media thickness (cIMT), are lacking. We aimed to investigate activin A and follistatin levels and their associations with cIMT. In total, 470 inhabitants of I-Lan county (235 men; mean age 69 ± 9 years) with measurements of serum activin A and follistatin levels were included. Patients with prediabetes and diabetes had significantly increased activin A concentrations compared with those in the normal glycemic group (both p < 0.001). A multivariable logistic regression model demonstrated that the circulating activin A level was associated with prediabetes and diabetes independently of other risk factors. Moreover, the circulating activin A levels were associated positively with cIMT in prediabetes (rs = 0.264, p = 0.001). In conclusion, activin A level, but not follistatin, was elevated independent of demographic variables with borderline significance and was correlated positively with cIMT in prediabetes. Activin A and follistatin levels were elevated in diabetes. In addition, elevated activin A was an independent risk factor for prediabetes and diabetes.

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Association between low-grade albuminuria and frailty among community-dwelling middle-aged and older people: a cross-sectional analysis from I-Lan Longitudinal Aging Study

Cited by 22 publications

References 29 publications

Sex differences in the contribution of different physiological systems to physical function in older adults

Sex differences in the contribution of different physiological systems to physical function in older adults

The urine albumin-creatinine ratio is a predictor for incident long-term care in a general population

Increased activin A levels in prediabetes and association with carotid intima-media thickness: a cross-sectional analysis from I-Lan Longitudinal Aging Study

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