Association between low-grade albuminuria and frailty among community-dwelling middle-aged and older people: a cross-sectional analysis from I-Lan Longitudinal Aging Study.

Chun-Chin Chang,Ting-Yung Chang,Jaw-Wen Chen,Li-Kuo Liu,Liang-Kung Chen,Chien-Yi Hsu,Shing-Jong Lin,Po-Hsun Huang

doi:10.1038/srep39434

Abstract

Frailty is characterized by decreased physiological reserve and increased vulnerability to atherosclerosis and subsequent mortality. Recently, low-grade albuminuria has been proposed as an atherosclerotic risk factor. We aimed to investigate the relationship between low-grade albuminuria and frailty by using cross-sectional data among community-dwelling middle-aged and older people. Totally, 1,441 inhabitants of I-Lan County with normal urinary albumin excretion (urine albumin to urine creatinine ratio [UACR] <30 mg/g) were enrolled (677 men; mean age 63 ± 9 years, range from 50 to 91 years old). Assessment of frailty was based on the ‘Fried frailty phenotype’ criteria, including weight loss, grip strength, exhaustion, slowness and low physical activity. The study population was stratified into quartiles according to UACR levels. Age, body mass index, hypertension, diabetes, systolic blood pressure, insulin resistance, fasting glucose and high-sensitivity C-reactive protein levels were increased with the increment of UACR (P for trend <0.05). The prevalence of prefrailty/frailty and its components increased across the UACR quartiles. A multivariate stepwise logistic regression analysis revealed that UACR was independently associated with the likelihood of prefrailty/frailty (odds ratio 1.13, 95% CI 1.01–1.27). In conclusion, low-grade albuminuria is associated with the increased prevalence of prefrailty/frailty.

Highlights

The presence of microalbuminuria, defined as a urine albumin-to-creatinine ratio (UACR) of 30 to 300 mg/g, is associated with progression of atherosclerotic vascular disease, elevated levels of inflammation markers, increased risk of osteoporotic fracture and the risk of cardiovascular events in both diabetic and nondiabetic individuals[6,7,8,9]
The main question addressed by the present study was whether UACR below the current microalbuminuria threshold was associated with prefrailty/frailty in elderly adults
Our study first demonstrated that low-grade albuminuria was significantly associated with prefrailty/frailty after adjusting other risk factors

Summary

Introduction

The presence of microalbuminuria, defined as a urine albumin-to-creatinine ratio (UACR) of 30 to 300 mg/g, is associated with progression of atherosclerotic vascular disease, elevated levels of inflammation markers, increased risk of osteoporotic fracture and the risk of cardiovascular events in both diabetic and nondiabetic individuals[6,7,8,9]. Increasing evidence has shown that low-grade albuminuria, defined as UACR as 0 to 30 mg/g, an earlier stage with UACR below the microalbuminuria threshold, is associated with an increased risk of incident cardiovascular disease and all-cause mortality[10,11,12]. The aim of the present study is to investigate the relationship between low-grade albuminuria and frailty. We tested the hypothesis that the degree of low-grade albuminuria is associated with the status of frailty by using cross-sectional analysis among a community-based cohort (ILAS cohort) in Taiwan

Objectives

Methods

Results

Conclusion