Abstract

BackgroundChronic inflammation is considered to affect physical performance, muscle strength and muscle mass, i.e. measures of sarcopenia. We need to identify a marker of inflammation that is univocally associated with measures of sarcopenia. We aimed to associate three markers of inflammation, erythrocyte sedimentation rate, albumin and white blood cell count, with measures of sarcopenia in geriatric outpatients.MethodsData from the Centre Of Geriatrics Amsterdam cohort was used. Geriatric outpatients at the VU university medical centre in Amsterdam were recruited based on referral between January 1st 2014 and the 31st of December 2015. Erythrocyte sedimentation rate, albumin and white blood cell count were assessed from venous blood samples. Measures of sarcopenia included physical performance by measuring gait speed with the 4 meter walk test, duration of the timed up and go test and of the chair stand test, muscle strength by assessing handgrip strength using handheld dynamometry and skeletal muscle mass by performing bioelectrical impedance analysis. Multivariable linear regression analyses were performed to assess the associations between erythrocyte sedimentation rate, albumin, white blood cell count and measures of sarcopenia.ResultsA total of 442 patients (mean age 80.8 years, SD 6.7, 58.1% female) were included. A higher erythrocyte sedimentation rate was significantly associated with lower gait speed (β = − 0.005; 95% CI = − 0.007, − 0.003), longer duration of timed up and go test (Ln β = 0.006; 95% CI = 0.003, 0.010), longer duration of chair stand test (Ln β = 0.005; 95% CI = 0.002, 0.008), lower handgrip strength (β = − 0.126; 95% CI = − 0.189, − 0.063) and lower relative skeletal muscle mass (β = − 0.179; 95% CI = − 0.274, − 0.084). Lower albumin levels were significantly associated with lower gait speed (β = − 0.020; 95% CI = − 0.011, − 0.028) and handgrip strength (β = − 0.596; 95% CI = − 0.311, − 0.881). Associations remained significant after adjustment for age, sex and number of morbidities. No significant associations were found for white blood cell count and measures of sarcopenia.ConclusionsIn geriatric outpatients, erythrocyte sedimentation rate was associated with all three measures of sarcopenia, underpinning the potential role of inflammation in sarcopenia.

Highlights

  • Chronic inflammation is considered to affect physical performance, muscle strength and muscle mass, i.e. measures of sarcopenia

  • In geriatric outpatients, erythrocyte sedimentation rate was associated with all three measures of sarcopenia, underpinning the potential role of inflammation in sarcopenia

  • TNF-α, IL-6, albumin and C-reactive protein (CRP) have shown a relation with the development of low muscle strength or muscle mass over time [8, 13,14,15], the current body of evidence fails to reveal a marker of chronic inflammation that is univocally associated with measures of sarcopenia in older people [18, 19]

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Summary

Introduction

Chronic inflammation is considered to affect physical performance, muscle strength and muscle mass, i.e. measures of sarcopenia. Inflammatory markers that have been investigated in relation to sarcopenia showed contradicting results, including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), albumin, white blood cell (WBC) count, cytokines (e.g. Tumor Necrosis Factor-α (TNF-α), Interleukine-6 (IL-6)) and its soluble receptors [8,9,10,11,12,13,14,15,16]. TNF-α, IL-6, albumin and CRP have shown a relation with the development of low muscle strength or muscle mass over time [8, 13,14,15], the current body of evidence fails to reveal a marker of chronic inflammation that is univocally associated with measures of sarcopenia in older people [18, 19]

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