Association between Oxidative Stress and Frailty in an Elderly German Population: Results from the ESTHER Cohort Study.
BACKGROUND
Oxidative stress (OS) and inflammatory biomarkers have been postulated to be important factors in the development of age-related diseases. While causes of frailty are complex and multidimensional based on the interaction of genetic, biological, physical, and environmental factors, the biological basis of frailty has been difficult to establish.


OBJECTIVE
In this study, we aimed to assess the possible association between different OS and inflammatory biomarkers and frailty.


METHODS
This cross-sectional analysis was performed among 2,518 subjects participating in a large population-based cohort study on aging conducted in Germany. Frailty was assessed as proposed by Fried et al. [J Gerontol A Biol Sci Med Sci 2001;56:M146-M156]. OS biomarkers, biological antioxidant potential (BAP), derivate of reactive oxygen metabolites (d-ROM) and total thiol levels (TTL), and an established biomarker of inflammation C-reactive protein (CRP) were measured by spectrophotometry and immunoturbidimetry. Logistic regression models were performed to assess the relationship between the OS biomarkers and frailty status. Odds ratios (OR) and 95% confidence intervals (CI) were calculated to quantify the associations.


RESULTS
Mean levels of d-ROM, TTL, and CRP differed between frail and non-frail participants (p values <0.0001). Comparing highest and lowest quartiles of the biomarkers, statistically significant positive associations with frailty were observed for d-ROM (OR: 2.02, 95% CI: 1.25-3.25) and CRP (OR: 3.15, 95% CI: 2.00-4.96), respectively, after controlling for age and sex. An inverse statistically significant association with frailty was observed for TTL (OR: 0.42, 95% CI: 0.25-0.69).


CONCLUSIONS
The strong associations with OS biomarkers and CRP support a major role of OS and inflammation in the development of frailty, which should be followed up in further longitudinal studies on frailty.
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Kai-Uwe
KU
Saum
Aida Karina
AK
Dieffenbach
Eugène H J M
EH
Jansen
Ben
B
Schöttker
Bernd
B
Holleczek
Klaus
K
Hauer
Hermann
H
Brenner
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D005858:Germany; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D016015:Logistic Models; D008297:Male; D018384:Oxidative Stress; D017382:Reactive Oxygen Species / Q000097:blood; D013438:Sulfhydryl Compounds / Q000097:blood
D015415:Biomarkers; D018836:Inflammation Mediators; D017382:Reactive Oxygen Species; D013438:Sulfhydryl Compounds; D002097:C-Reactive Protein