The journal of nutrition, health & aging

, Volume 16, Issue 8, pp 679-686

First online:

Frailty status and altered dynamics of circulating energy metabolism hormones after oral glucose in older women

  • Rita Rastogi KalyaniAffiliated withDivision of Endocrinology, Johns Hopkins Medical Institutions Email author 
  • , R. VaradhanAffiliated withDivision of Geriatric Medicine and Gerontology and Center on Aging and Health, Johns Hopkins Medical Institutions
  • , C. O. WeissAffiliated withDivision of Geriatric Medicine and Gerontology, College of Human Medicine of Michigan State University
  • , L. P. FriedAffiliated withDepartment of Epidemiology, Mailman School of Public Health, Columbia University
  • , A. R. CappolaAffiliated withDivision of Endocrinology, Diabetes and Metabolism, Perelman School of Medicine at the University of Pennsylvania

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Frailty status is associated with altered glucose-insulin dynamics. Here, we sought to investigate whether alteration in the dynamics of other circulating energy metabolism hormones after oral glucose is associated with frailty status.


Substudy of older women in a prospective cohort.


Baltimore, Maryland.


Seventy-three community-dwelling women aged 84–95 years without a diagnosis of diabetes who were enrolled in the Women’s Health and Aging Study II.


We examined stimulus-response dynamics of free fatty acids (FFA), gut- (ghrelin, GLP-1) and adipocyte-derived hormones (leptin, adiponectin, resistin), growth hormone (GH), insulin-like growth factor 1 (IGF-1), and interleukin-6 (IL-6) at 0, 30, 60, 120, and 180-minutes after a 75-g glucose challenge according to frailty status (non-frail, pre-frail, or frail).


On average, frail women had higher fasting levels of glucose-raising hormones (FFA, resistin, GH, and IL-6) and lower fasting levels of glucose-lowering hormones (ghrelin, adiponectin, GLP-1 and IGF-1) versus non-frail women but these results were not statistically significant. Frail women also had higher fasting levels of leptin with relative adiposity compared to their counterparts, suggestive of leptin-resistance. integrated area under the curve (AUC) values for each hormone followed similar trends by frailty status. After age and BMI adjustment, frail versus non-frail women were more likely to be in the lowest tertile of fasting ghrelin levels and 120-min ghrelin levels (both p<0.05) in logistic regression analyses. No large differences were found for other hormones in adjusted models.


Our findings suggest dysregulation of the orexigenic hormone ghrelin in the frailty syndrome. Further studies are needed to explore the role of ghrelin dysregulation in the clinical manifestation of frailty.

Key words

Frailty energy metabolism insulin glucose