Oxidative Stress, Telomere Shortening, and Apoptosis Associated to Sarcopenia and Frailty in Patients with Multimorbidity
Abstract
:1. Introduction
2. Patients and Methods
2.1. Development of the Study
2.2. Biological Parameters Determination
3. Results
3.1. Oxidative Stress Markers
3.2. Absolute Telomere Length Analysis
3.3. Apoptosis
3.4. Functional Parameters, Death Risk by PROFUND Index and Survival according to Different Molecular Parameters
4. Discussion
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Clinical Features | Mean (SD)/Median -IQR-/N (%) |
---|---|
Number of defining categories (major diseases) per patient | 2.5 (0.5) |
Prevalence of defining categories (major diseases) | |
Heart diseases | 374 (84.6%) |
Kidney/autoimmune diseases | 202 (45.7%) |
Lung diseases | 183 (41.4%) |
Neurological diseases | 133 (30.1%) |
Peripheral arterial disease/diabetes with neuropathy | 80 (18.1%) |
Neoplasia/chronic anemia | 70 (15.8%) |
Degenerative osteoarticular disease | 43 (9.7%) |
Liver disease | 28 (6.3%) |
Number of other comorbidities per patient | 5.9 (2.3) |
Most frequent comorbidities | |
Hypertension | 380 (86%) |
Dyslipemia | 232 (52.5%) |
Diabetes with no visceral involvement | 216 (49%) |
Atrial fibrillation | 178 (40%) |
Obesity | 159 (36%) |
Anxiety and depressive disorders | 74 (17%) |
Benign prostate hyperplasia | 64 (14.5%) |
Frequent symptoms | |
Fatigue | 304 (70%) |
Anorexia | 212 (48%) |
Insomnia | 194 (44%) |
Chronic pain | 178 (40%) |
Cough | 158 (36%) |
Patients with basal III-IV class of NYHA//III–IV class of mMRC | 128 (29%) |
PROFUND index | 6 -6- |
Basal Barthel’s Index | 66 (30) |
BMI (Kg/m2) | 30 (6.6%) |
Main biological parameters | |
Hemoglobin (d/dL) | 11.3 (2) |
Creatinin (mg/dL) | 1.26 (1) |
Albumin (g/dL) | 3.2 (0.9) |
Cholesterol (mg/dL) | 151 (42) |
Triglicerydes (mg/dL) | 116 -80- |
Vitamin D (ng/mL) | 11 -17- |
Leucocytes (n°/µL) | 8000 -4000- |
Lymphocytes (n°/µL) | 1200 -400- |
Molecular Parameter | Sarcopenia and Frailty Assessment | p | |
---|---|---|---|
Sarcopenia | Not Sarcopenic | Sarcopenic | |
Oxidative stress marker | |||
CAT | 52 (12.6–82) * | 58 (29.4–87.8) | 0.16 |
GR | 9.8 (6.8–13.4) | 9.9 (5.5–13) | 0.45 |
TAC-ROS | 2.42 (1.8–3) | 2.29 (1.75–2.8) | 0.12 |
SOD | 4.4 (2.7–6.5) | 5.8 (3.7–6.9) | 0.02 |
Absolute telomere length | 4.96 (0.7–19) | 1.65 (0.6–3.9) | 0.001 |
Apoptosis (WBC DNA fragmentation) | No evidence | No evidence | - |
Frailty | Robust | Frail | |
Oxidative stress marker | |||
CAT | 55.6 (21.7–80) | 51.4 (19–83.5) | 0.6 |
GR | 9.1 (5.3–9) | 10.2 (6.9–13.5) | 0.12 |
TAC-ROS | 3.5 (1.6–9) | 3.3 (1.9–3) | 0.044 |
SOD | 3.8 (2.3–6.2) | 5.1 (3.2–7) | 0.002 |
Absolute telomere length | 5.7 (1.7–19) | 1.5 (0.6–3.4) | <0.0001 |
Apoptosis (WBC DNA fragmentation) | No evidence | No evidence | - |
Sarcopenia and Frailty | Not Sarcopenic and Robust | Sarcopenic and Frail | |
Oxidative stress marker | |||
CAT | 46.4 (46.5–77.5) | 51.5 (26.2–79) | 0.2 |
GR | 9.7 (6.7–13.2) | 10.1 (5.9–14) | 0.5 |
TAC-ROS | 2.4 (1.8–3.1) | 2.2 (1.8–2.8) | 0.08 |
SOD | 4.4 (2.8–6.4) | 5.7 (4.1–6.4) | 0.0012 |
Absolute telomere length | 6.5 (0.7–20) | 1.5 (0.6–3.8) | <0.0001 |
Apoptosis (WBC DNA fragmentation) | No evidence | No evidence | - |
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Bernabeu-Wittel, M.; Gómez-Díaz, R.; González-Molina, Á.; Vidal-Serrano, S.; Díez-Manglano, J.; Salgado, F.; Soto-Martín, M.; Ollero-Baturone, M.; on behalf of the PROTEO RESEARCHERS. Oxidative Stress, Telomere Shortening, and Apoptosis Associated to Sarcopenia and Frailty in Patients with Multimorbidity. J. Clin. Med. 2020, 9, 2669. https://doi.org/10.3390/jcm9082669
Bernabeu-Wittel M, Gómez-Díaz R, González-Molina Á, Vidal-Serrano S, Díez-Manglano J, Salgado F, Soto-Martín M, Ollero-Baturone M, on behalf of the PROTEO RESEARCHERS. Oxidative Stress, Telomere Shortening, and Apoptosis Associated to Sarcopenia and Frailty in Patients with Multimorbidity. Journal of Clinical Medicine. 2020; 9(8):2669. https://doi.org/10.3390/jcm9082669
Chicago/Turabian StyleBernabeu-Wittel, Máximo, Raquel Gómez-Díaz, Álvaro González-Molina, Sofía Vidal-Serrano, Jesús Díez-Manglano, Fernando Salgado, María Soto-Martín, Manuel Ollero-Baturone, and on behalf of the PROTEO RESEARCHERS. 2020. "Oxidative Stress, Telomere Shortening, and Apoptosis Associated to Sarcopenia and Frailty in Patients with Multimorbidity" Journal of Clinical Medicine 9, no. 8: 2669. https://doi.org/10.3390/jcm9082669