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

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Abstract

Traditional risk factors of cardiovascular death in the general population, including body mass index (BMI), serum cholesterol, and blood pressure are also found to relate to outcomes in the geriatric population, but in a differing direction. A higher body mass index, hypercholesterolemia and hypertension are not harmful but even permit better survival at advancing age. This phenomenon is called “reverse epidemiology” or “risk factor paradox” and is also detected in a variety of chronic disease states such as chronic heart failure. Accordingly, a low BMI, blood pressure and cholesterol values are associated with a worse prognosis. Several possible causes are hypothesized to explain this elderly paradox, but this phenomenon remains controversial and its underlying reasons are poorly understood. The aim of this review is to recognize the factors behind this intriguing phenomenon and analyse the consequences that it can bring in the management of the cardiovascular therapy in elderly patient. Finally, a new phenotype identified as “catabolic syndrome” has been postulated.

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Fig. 1

(modified with permission by Testa et al.)

Fig. 2

(with permission by Flicker L et al.)

Fig. 3

(modified with permission by Schatz IJ et al.)

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Authors and Affiliations

  1. Department of Translational Medical Sciences, University of Naples “Federico II”, Via S. Pansini, 80131, Naples, Italy

    Francesco Curcio, Giuseppe Sasso, Ilaria Liguori, Gennaro Russo, Michele Cellurale, Gianluca Testa, Francesco Cacciatore, Domenico Bonaduce & Pasquale Abete

  2. Department of Emergency, A.O.R.N. Antonio Cardarelli, Naples, Italy

    Gaetana Ferro

  3. Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy

    David Della-Morte

  4. San Raffaele Roma Open University, 00166, Rome, Italy

    David Della-Morte

  5. Division of Internal Medicine, AOU San Giovanni di Dio e Ruggi di Aragona, Salerno, Italy

    Gaetano Gargiulo

  6. Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy

    Gianluca Testa

  7. Heart Transplantation Unit, Monaldi Hospital, Azienda Ospedaliera dei Colli, Naples, Italy

    Francesco Cacciatore

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  1. Francesco Curcio
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  2. Giuseppe Sasso
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Correspondence to Pasquale Abete.

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Curcio, F., Sasso, G., Liguori, I. et al. The reverse metabolic syndrome in the elderly: Is it a “catabolic” syndrome?. Aging Clin Exp Res 30, 547–554 (2018). https://doi.org/10.1007/s40520-017-0815-7

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