Metabolic Syndrome Predicts Frailty

Abstract

SAN FRANCISCO — Elderly individuals who have metabolic syndrome are about twice as likely to become frail as those who are healthy, Dr. Joshua I. Barzilay reported in a poster presentation at the Third World Congress on Insulin Resistance Syndrome. The study involved 2,376 individuals aged 69–74 who were followed prospectively for 7–9 years. At baseline none of the participants were frail, nor did they have other illnesses that increase inflammation markers or mimic frailty, reported Dr. Barzilay, of Emory University, Atlanta, and his colleagues. A participant was considered frail if he or she met at least three of the following five criteria: unintentional weight loss of 10 pounds or more in the previous year, low grip strength, self-reported exhaustion, slowness in walking, and low exercise tolerance. A participant was considered “prefrail” if he or she met one or two of the criteria. At the end of follow-up, 169 participants qualified as frail and another 1,082 qualified as prefrail. The three most commonly seen components of frailty were diminished walking speed, diminished strength, and diminished activity, all of which are consistent with sarcopenia. Participants who developed frailty or prefrailty had significantly higher fasting insulin levels, higher white blood cell counts, higher C-reactive protein levels, and higher factor VII levels than those who didn't develop frailty. These participants were 30%–100% more likely to have metabolic syndrome at baseline, compared with those who did not develop frailty or prefrailty. The most common components of the metabolic syndrome in this cohort were increased girth and increased homeostatic model assessment scores. They were also significantly more likely to have developed diabetes at follow-up. In view of the fact that frailty was defined mostly by sarcopenia, the investigators wrote, insulin resistance, inflammation, and frailty are all related to a primary disorder of muscle metabolism.