PMID- 32517659
OWN - NLM
STAT- MEDLINE
DCOM- 20201221
LR  - 20201221
IS  - 1471-2318 (Electronic)
IS  - 1471-2318 (Linking)
VI  - 20
IP  - 1
DP  - 2020 Jun 9
TI  - Low serum albumin, aspartate aminotransferase, and body mass are risk factors for 
      frailty in elderly people with diabetes-a cross-sectional study.
PG  - 200
LID - 10.1186/s12877-020-01601-z [doi]
LID - 200
AB  - BACKGROUND: Frailty is broadly characterized by vulnerability and decline in 
      physical, mental and social activities and is more common in elderly patients 
      with type 2 diabetes mellitus (T2DM). Frailty is closely associated with 
      nutrition, muscle strength, inflammation, and hormones etc. In hormones, 
      dehydroepiandrosterone sulfate (DHEA-S) and cortisol are suggested to be such 
      candidates affecting frailty. Little investigation has been performed using a 
      wider range of measures of frailty to clarify risk factors for frailty including 
      the above two hormones. METHODS: We performed a cross-sectional study to 
      investigate the risk factors for frailty in elderly T2DM patients (n = 148; 
      >/=65 years), using a broad assessment, the clinical frailty scale. We compared 
      parameters between the non-frail and frail groups using the unpaired t and 
      Mann-Whitney U tests. The Jonckheere-Therpstra test was used to identify 
      relationships with the severity of frailty, and risk factors were identified 
      using binary regression analysis. RESULTS: Simple regression analysis identified 
      a number of significant risk factors for frailty, including DHEAS < 70 mug/dL and 
      cortisol/DHEA-S ratio >/= 0.2. Multiple regression analysis showed that low albumin 
      (< 4.0 g/dl) (odds ratio [OR] = 5.79, p < 0.001), low aspartate aminotransferase 
      (AST) activity (< 25 IU/L) (OR = 4.34, p = 0.009), and low body mass (BM) 
      (< 53 kg) (OR = 3.85, p = 0.012) were independent risk factors for frailty. A 
      significant decrease in DHEA-S and a significant increase in the cortisol/DHEA-S 
      ratio occurred alongside increases in the severity of frailty. DHEA-S 
      concentration positively correlated with both serum albumin and BM. CONCLUSIONS: 
      Hypoalbuminemia, low AST, and low BM are independent risk factors for frailty in 
      elderly T2DM patients, strongly implying relative malnutrition in these frail 
      patients. DHEA-S may be important for the maintenance of liver function and BM. A 
      decrease in DHEA-S and an increase in the cortisol/DHEAS ratio may be involved in 
      the mechanism of the effect of malnutrition in elderly T2DM patients.
FAU - Yanagita, Ikumi
AU  - Yanagita I
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Fujihara, Yuya
AU  - Fujihara Y
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Iwaya, Chikayo
AU  - Iwaya C
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Kitajima, Yuichi
AU  - Kitajima Y
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Tajima, Misuzu
AU  - Tajima M
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Honda, Masanao
AU  - Honda M
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Teruya, Yuji
AU  - Teruya Y
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Asakawa, Hideko
AU  - Asakawa H
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Ito, Tomoko
AU  - Ito T
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Eda, Terumi
AU  - Eda T
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Yamaguchi, Noriko
AU  - Yamaguchi N
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Kayashima, Yumi
AU  - Kayashima Y
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Yoshimoto, Mihoko
AU  - Yoshimoto M
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Harada, Mayumi
AU  - Harada M
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Yoshimoto, Shoji
AU  - Yoshimoto S
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Aida, Eiji
AU  - Aida E
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Yanase, Toshihiko
AU  - Yanase T
AUID- ORCID: 0000-0003-2971-9943
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan. 
      t-yanase@seiwakai-hp.jp.
AD  - Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. 
      t-yanase@seiwakai-hp.jp.
FAU - Nawata, Hajime
AU  - Nawata H
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
FAU - Muta, Kazuo
AU  - Muta K
AD  - Muta Hospital, 3-9-1 Hoshikuma, Sawara-ku, Fukuoka, 814-0163, Japan.
LA  - eng
PT  - Journal Article
DEP - 20200609
PL  - England
TA  - BMC Geriatr
JT  - BMC geriatrics
JID - 100968548
RN  - 0 (Serum Albumin)
RN  - 57B09Q7FJR (Dehydroepiandrosterone Sulfate)
RN  - EC 2.6.1.1 (Aspartate Aminotransferases)
SB  - IM
MH  - Aged
MH  - Aspartate Aminotransferases
MH  - Cross-Sectional Studies
MH  - Dehydroepiandrosterone Sulfate
MH  - *Diabetes Mellitus, Type 2/diagnosis/epidemiology
MH  - *Frailty/diagnosis/epidemiology
MH  - Humans
MH  - Risk Factors
MH  - Serum Albumin
PMC - PMC7285748
OTO - NOTNLM
OT  - Albumin
OT  - DHEA-S
OT  - Frailty
OT  - Transaminase
OT  - Type 2 diabetes
COIS- The authors declare that they have no competing interests.
EDAT- 2020/06/11 06:00
MHDA- 2020/12/22 06:00
PMCR- 2020/06/09
CRDT- 2020/06/11 06:00
PHST- 2020/02/02 00:00 [received]
PHST- 2020/06/04 00:00 [accepted]
PHST- 2020/06/11 06:00 [entrez]
PHST- 2020/06/11 06:00 [pubmed]
PHST- 2020/12/22 06:00 [medline]
PHST- 2020/06/09 00:00 [pmc-release]
AID - 10.1186/s12877-020-01601-z [pii]
AID - 1601 [pii]
AID - 10.1186/s12877-020-01601-z [doi]
PST - epublish
SO  - BMC Geriatr. 2020 Jun 9;20(1):200. doi: 10.1186/s12877-020-01601-z.