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

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

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.

Design

Substudy of older women in a prospective cohort.

Setting

Baltimore, Maryland.

Participants

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.

Measurements

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).

Results

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.

Conclusions

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.

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Author information

Authors and Affiliations

  1. Division of Endocrinology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA

    Rita Rastogi Kalyani

  2. Division of Geriatric Medicine and Gerontology and Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA

    R. Varadhan

  3. Division of Geriatric Medicine and Gerontology, College of Human Medicine of Michigan State University, Grand Rapids, USA

    C. O. Weiss

  4. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA

    L. P. Fried

  5. Division of Endocrinology, Diabetes and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    A. R. Cappola

  6. 1830 East Monument Street, Suite 333, Baltimore, MD, 21287, USA

    Rita Rastogi Kalyani

Authors
  1. Rita Rastogi Kalyani
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  2. R. Varadhan
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  3. C. O. Weiss
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  4. L. P. Fried
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  5. A. R. Cappola
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Correspondence to Rita Rastogi Kalyani.

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Kalyani, R.R., Varadhan, R., Weiss, C.O. et al. Frailty status and altered dynamics of circulating energy metabolism hormones after oral glucose in older women. J Nutr Health Aging 16, 679–686 (2012). https://doi.org/10.1007/s12603-012-0066-4

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  • DOI: https://doi.org/10.1007/s12603-012-0066-4

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