title: Nitric oxide (NO) is a new clinical biomarker of survival in the elderly patients and its efficacy might be nearly equal to albumin.
abstract: BACKGROUND
  For elderly patients, the consideration of prognostic factors is very important, but there have been few reports about the potential use of vasoactive substances as prognostic markers in the elderly.
  
  
  OBJECTIVE
  We assessed endocrinological substances, such as plasma NO(x) (metabolites of NO), as the prognostic marker in elderly. We compared their efficacy with that of such well-known markers as albumin and pro-inflammatory cytokines such as IL-6.
  
  
  METHODS
  The patients were recruited consequently from the clinics of Nagoya University Hospital or related home care services facilities. One hundred and twenty seven elderly aged 65 and older were registered. Biochemical analyses such as albumin, total cholesterol, BNP, and NO(x) were measured upon enrollment. The main outcome was the survival rate.
  
  
  RESULTS
  Forty-six patients died during the follow-up period. Mann-Whitney's U-test showed that the levels of age, hemoglobin, total protein, serum albumin, serum creatinine, total cholesterol, HDL-cholesterol, LDL-cholesterol, high sensitive CRP, NO(x), IL-6, and TNF-alpha were significantly different between the living and deceased subjects. Among the dependent variables in the logistic regression analyses, only albumin and NO(x) were significantly different. In the Kaplan-Meier analyses of mortality, the prognosis of patients in 3rd and 4th quartile of NO(x) was significantly worse than that in 1st or 2nd quartile.
  
  
  CONCLUSIONS
  NO(x) has potential both as a vascular marker and as a marker for predicting survival in elderly. In the latter role, it may be as effective as albumin.
authors.affiliation: Department of Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya City 466-8550, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Osawa
authors.forename: Toshio
authors.initials: T
authors.lastname: Hayashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Nomura
authors.forename: Jun
authors.initials: J
authors.lastname: Funami
authors.forename: Asaka
authors.initials: A
authors.lastname: Miyazaki
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Ignarro
authors.forename: Akihisa
authors.initials: A
authors.lastname: Iguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D019963:Clinical Chemistry Tests; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009569:Nitric Oxide / Q000097:blood*; D011379:Prognosis; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D009569:Nitric Oxide