title: Hormonal determinants and effect of ER22/23EK glucocorticoid receptor gene polymorphism on health status deterioration in the participants of the Mataró Ageing Study.
abstract: The purpose of this study is to assess the potential relationships of circulating IGF-I, adrenal and gonadal steroids, and polymorphism ER22/23EK of the glucocorticoid receptor (GC-R) gene with nutritional, functional and cognitive deterioration in a group of elderly people living independently. This is a population-based prospective study with 313 individuals (160 women and 153 men, 76.7 ± 7 years) who participated. A physical exam, evaluation of functional capacity (Barthel scale), cognitive function (mini-mental state examination-MMSE), geriatric depression scale (GDS), mininutritional assessment (MNA-SF) and cardiometabolic status were performed at basal time point and at 2 years of follow-up. Biological measurements included cortisol, dehydroepiandrosterone (DHEA), DHEA sulphate, testosterone, estradiol, IGF-I and polymorphism ER22/23EK of the GC-R gene. Estradiol was associated with MNA-SF decrease over time (p < 0.01, adjusted for age and gender, beta = -0.17, p = 0.03). Weight loss was related to testosterone in men (8.6 vs 12.1 pg/ml in no losers; p = 0.03), and in women with GDS (13.0% with depression vs 3.3% with no depression; p = 0.05) and MMSE (22.2% with cognitive deterioration vs 4.8% with no cognitive deterioration; p = 0.049). Barthel decrease was associated with testosterone (p = 0.02, after adjusting for age and gender, beta = -0.520, p < 0.001), and SHBG (p < 0.01, adjusted for age and gender, beta = 0.18, p < 0.01). DHEA was associated with deterioration in the MMSE (p = 0.01, after adjusting for age, gender, GDS scale and academic status, beta = -0.26, p = 0.01). Frailty development was related only in men with testosterone levels at the beginning of the study (p = 0.017). ER22/23EK was found in 3% of the subjects and carriers had a lower prevalence of hypertension. Adrenal and gonadal steroids are associated to impairment of the ageing health condition in elderly individuals living independently in Spain. ER22/23EK polymorphism of the GC-R gene has a low prevalence in our population.
authors.affiliation: Department of Endocrinology and Nutrition, Hospital Clínic, University of Barcelona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Mora
authors.forename: Lidia
authors.initials: L
authors.lastname: Sánchez
authors.forename: Mateu
authors.initials: M
authors.lastname: Serra-Prat
authors.forename: Elisabet
authors.initials: E
authors.lastname: Palomera
authors.forename: Jesús
authors.initials: J
authors.lastname: Blanco
authors.forename: Gloria
authors.initials: G
authors.lastname: Aranda
authors.forename: Immaculada
authors.initials: I
authors.lastname: Falcón
authors.forename: Immaculada
authors.initials: I
authors.lastname: Cadenas
authors.forename: Xavier
authors.initials: X
authors.lastname: Boquet
authors.forename: Josep
authors.initials: J
authors.lastname: Oriola
authors.forename: Manuel
authors.initials: M
authors.lastname: Puig-Domingo
mesh_terms: D000368:Aged; D000375:Aging / Q000097:blood / Q000235:genetics*; D003071:Cognition / Q000502:physiology*; D004247:DNA / Q000235:genetics*; D003863:Depression / Q000097:blood / Q000453:epidemiology / Q000235:genetics; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D006304:Health Status; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology / Q000235:genetics; D009043:Motor Activity / Q000235:genetics*; D010641:Phenotype; D011110:Polymorphism, Genetic; D015995:Prevalence; D011446:Prospective Studies; D011965:Receptors, Glucocorticoid / Q000097:blood / Q000235:genetics*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
chemical_list: D011965:Receptors, Glucocorticoid; D004247:DNA