Abstract
With aging, intact parathyroid hormone (iPTH) increases. It plays a crucial role in left ventricular hypertrophy (LVH). Also, 25-hydroxy vitamin D (Vit-D) and iPTH have been observed to be determinants of muscle wasting known as sarcopenia. Fetuin A (FetA), a systemic calcification inhibitor, involves in the development of diastolic heart failure. Hence, we hypothesized that the interplay among FetA, Vit-D and iPTH may contribute to sarcopenic LVH among the elders. We analyzed a database from the Tianliao Old People study with 541 elders (≥65 years) in a Taiwan’s suburban community. After excluding patients with renal function impairment, 120/449 (26.7%) patients were diagnosed with sarcopenia. Sarcopenic patients had lower serum Vit-D levels but higher FetA as well as iPTH. Notably, sarcopenic patients with LVH had significantly lower FetA and higher iPTH levels. In multivariate logistic regression analysis, only the increase in iPTH was independently associated with sarcopenic LVH (Odds ratio: 1.05; confidence interval: 1.03–1.08, p = 0.005). Using iPTH >52.3 ng/l as a cutoff point, the sensitivity and specificity was 66% and 84%, respectively. In conclusion, FetA, Vit-D, and iPTH levels were all associated with sarcopenia in this geriatric population. Among them, iPTH specifically indicates patients with sarcopenic LVH.
Highlights
With aging, the incidence of sarcopenia, an involuntary reduction in fatty-free muscle mass, and cardiac hypertrophy increases[1,2,3,4]
We previously reported a high concentration of FetA was associated with left ventricular dysfunction in participants with sarcopenia[19]
One hundred twenty (26.7%) of the 449 participants were diagnosed with sarcopenia (Sarc+)
Summary
The incidence of sarcopenia, an involuntary reduction in fatty-free muscle mass, and cardiac hypertrophy increases[1,2,3,4]. A growing number of studies have reported a continuous loss of myocytes subsequent to reactive hypertrophy of the remaining cells in age-related cardiac changes, or cells filled with fibrotic, adipose tissue in the extracellular matrix[4,5]. In a longitudinal aging study, low Vit-D and high PTH concentrations were concluded to be determinants of sarcopenia[10]. Fetuin-A (FetA) is a calcification inhibitor and is involved in insulin resistance[12,13,14,15,16] It was a potential regulator of cardiovascular disease, and recently reported to be a main factor in adjusting body composition remodeling in the geriatric population[17]. We aimed to study FetA, Vit-D, and PTH concentrations in the elderly (≥65 years old) with or without sarcopenia and left ventricular hypertrophy (LVH)
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