Cystatin C and Frailty in Older Men

• Autores: Allyson Hart, Misti L. Paudel, Brent C. Taylor, Areef Ishani, Eric S. Orwoll, Peggy M. Cawthon, Kristine E. Ensrud
• Localización: Journal of the American Geriatrics Society, ISSN 0002-8614, Vol. 61, Nº. 9, 2013, págs. 1530-1536
• Idioma: inglés
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• Resumen

  • Objectives: To determine whether higher cystatin C would be associated with greater frailty in men aged 65 and older.

    Design: Cross-sectional cohort study.

    Setting: Six U.S. sites.

    Participants: A random sample of community-dwelling men aged 65 and older enrolled in the Osteoporotic Fractures in Men (MrOS) Study (mean age 73.8; 9.8% frail and 47.2% intermediate frailty; N = 1,602).

    Measurements: Serum cystatin C, creatinine, and frailty were measured. Frailty was analyzed as an ordinal outcome of robust, intermediate frailty, and frail using a multinomial logistic regression model, and the base model was adjusted for age, race, and clinical site.

    Results: Higher cystatin C was associated with seven times greater odds of being frail than being robust (odds ratio (OR) quartile 4 vs 1 = 7.12, 95% confidence interval (CI) = 3.76�13.46) and 2.4 times greater odds of intermediate frailty than robust (OR quartile 4 vs 1 = 2.38, 95% CI = 1.70�3.32). The association was attenuated but persisted after adjusting for multiple possible confounders. In contrast, neither higher serum creatinine (OR quartile 4 vs 1 = 1.36, 95% CI = 0.78�2.40) nor lower creatinine-based estimated glomerular filtration rate (OR quartile 4 vs 1 = 1.01, 95% CI = 0.54�1.87) was associated in a graded manner with greater odds of frailty.

    Conclusion: Higher cystatin C, but not creatinine-based measures, was associated with greater odds of frailty in this cohort of older men.