Sains Malaysiana 48(3)(2019): 613-619

http://dx.doi.org/10.17576/jsm-2019-4803-14

Blood Inflammatory Markers, Anabolic Hormone, Vitamin D and L-Carnitine Status According to Frailty Status among Older Adults

(Penanda Inflamasi Darah, Hormon Anabolik, Vitamin D dan Status L-Karnitin menurut Status Keuzuran dalam Kalangan Warga Emas)

MANAL BADRASAWI^1,2, SUZANA SHAHAR^1*, NOR FADILAH RAJAB³ & DEVINDER KAUR AJIT SINGH⁴

¹Dietetic, Programme and Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Federal Territory, Malaysia

²Nutrition and Food Technology, Faculty of Agriculture, An-Najah National University, Palestine

³Biomedical Programme and Centre of Healthy Aging and Wellness, Faculty of Health Science, School of Healthcare Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Federal Territory, Malaysia

⁴Physiotherapy Programme and Centre for Rehabilitation and Special Needs, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Federal Territory, Malaysia

Received: 24 April 2018/Accepted: 9 January 2019

ABSTRACT

Frailty is associated with functional decline and reduced ability to cope with physiological challenges. The pathophysiological changes in frailty include inflammation, endocrine disturbances, neuromuscular and immune dysfunction. However, comprehensive information on the relationship between biological markers and frailty is scarce. We aimed to determine the relationship between selected biomarkers and frailty among Malaysian older adults. In this cross sectional study, 600 community dwelling older adults were randomly selected from ten different areas in Klang Valley. A total of 382 participants met the inclusion criteria and consented to the study. Out of these, a subsamples of 91 participants were selected for biomarkers analysis. Frailty was defined using Fried’s criteria. Fasting blood glucose, lipid profile, albumin, selected frailty biomarkers including IL-6, TNF- alpha and IGF-1 and vitamin D together with free L-carnitine and acetyl L-carnitine were analysed. The results showed a significantly higher level of serum IL-6 and TNF-α among participants classified as frail as compared to pre-frail and robust (p<0.05). With respect to nutritional biomarkers, binary logistic regression showed that vitamin D deficiency is associated with three times higher risk of frailty (p<0.05). There was no significant relationship between blood L-carnitines and frailty. Further research is required to explore the relationship between L-carnitine and frailty using different parameters involved in L-carnitine homeostasis such as CPTII enzyme and OCTN2 mutation. In conclusion, frailty was associated with increased level of inflammatory markers and vitamin D deficiency. It is empirical to promote healthy lifestyle or disease management to reduce inflammation and increase vitamin D status as one of the frailty prevention action plan among older adults.

Keywords: Anabolic hormone; frailty biomarkers; inflammatory mediators; L-carnitine; vitamin D

ABSTRAK

Keuzuran adalah berkaitan dengan kemerosotan status kefungisan dan keupayaan dalam menangani cabaran fisiologi. Perubahan patofisiologi keuzuran termasuklah ketakfungsian ototneuro, ketakupayaan fungsi imun, inflamasi dan gangguan endokrin. Namun begitu, tidak banyak penyelidikan yang mengkaji hubungan antara petunjuk biologi dan keuzuran secara menyeluruh. Oleh itu, kajian ini menentukan hubungan antara petunjuk biologi tertentu dan status keuzuran dalam kalangan warga emas. Seramai 600 orang warga emas daripada komuniti dipilih secara rawak dari 10 buah kawasan di Lembah Klang. Seramai 382 peserta memenuhi kriteria kajian dan bersetuju mengambil bahagian. Seramai 91 subjek dipilih daripada sampel keseluruhan untuk analisis petunjuk biologi. Keuzuran didefinasikan daripada kriteria Fried. Petunjuk biokimia keuzuran yang dikaji termasuk IL-6, TNF- alfa dan IGF-1 serta vitamin D, bersama-sama dengan L-karnitin bebas dan asetil L-karnitin dianalisis. Keputusan menunjukkan aras plasma darah IL-6 dan TNF-α adalah lebih tinggi secara signifikan dalam kumpulan uzur berbanding, prauzur dan robus (p<0.05). Berhubung dengan petunjuk biologi pemakanan, analisis logistik binari menunjukkan kekurangan vitamin D berkaitan dengan risiko keuzuran sebanyak tiga kali ganda (p<0.05). Tiada hubungan signifikan antara L-karnitin dalam plasma darah dengan keuzuran, oleh itu, penyelidikan lanjut diperlukan untuk mengkaji hubungan antara homeostasis L-karnitin seperti enzim CPTII dengan mutasi OCTN2. Kesimpulannya, keuzuran dikaitkan dengan peningkatan tahap penanda inflamasi dan kekurangan vitamin D. Terdapat keperluan untuk meningkatkan strategi promosi gaya hidup sihat atau pengurusan penyakit untuk menurunkan tahap keradangan dan meningkatkan aras vitamin D bagi mencegah keuzuran dalam kalangan warga emas.

Kata kunci: Keuzuran; L-karnitin; pengantara inflamasi; petunjuk biologi; vitamin D

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*Corresponding author; email: suzana.shahar@ukm.edu.my