title: Associations between frailty and serum N-terminal propeptide of type I procollagen and 25-hydroxyvitamin D in older Spanish women: The Toledo Study for Healthy Aging.
abstract: Frail older people are at high risk for fractures and falls increasing the rates of institutionalization and mortality. Bone markers have been related to both aging and fractures. However, no previous reports have shown a potential relationship between serum bone markers such as N-terminal propeptide of type I procollagen (PINP), C-terminal telopeptide of type I collagen (β-CTX) and parathyroid hormone (PTH) with frailty in elderly female populations. This study is aimed at examining the associations of bone metabolism markers and frailty in older Spanish women through a descriptive cross-sectional analysis based on a cohort of the Toledo Study for Healthy Aging (TSHA). The levels of serum PINP, β-CTX, PTH and 25-hydroxyvitamin D (25(OH)D) were assessed in 592 participants (median age 74years) who were defined as robust, prefrail and frail according to Fried's approach. Frail subjects had significantly high levels of PINP, β-CTX and PTH and low production of 25(OH)D. After adjustment for confounders, high PINP levels (defined by the upper quartile) and low levels of 25(OH)D (lower quartile) remained significantly associated to frailty [OR for PINP: 2.19 (95% CI, 1.15-4.18; P=0.017); OR for 25(OH)D: 1.65 (95% CI, 1.02-2.67; P=0.042)]. Women with both high PINP levels and low 25(OH)D levels presented a 5.85-fold increased frailty risk (95% CI, 1.64-20.93; P=0.007). The main contribution of this paper is the novel definition of PINP and 25(OH)D markers as potential biomarkers of frailty and targets for intervention.
authors.affiliation: Department of Clinical Biochemistry, Virgen del Rocío University Hospital (IBiS/CSIC/SAS/University of Seville), Seville, Spain.
authors.forename: Ana I
authors.initials: AI
authors.lastname: Alvarez-Ríos
authors.affiliation: Department of Clinical Biochemistry, Virgen del Rocío University Hospital (IBiS/CSIC/SAS/University of Seville), Seville, Spain; Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocio/CSIC/Universidad de Sevilla, Department of Medical Biochemistry and Molecular Biology and Immunology, University of Seville School of Medicine, Seville, Spain.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Guerrero
authors.affiliation: Division of Geriatric Medicine, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: García-García
authors.affiliation: Servicio de Geriatría y Fundación para la Investigación Biomédica, Hospital Universitario de Getafe Madrid, Spain.
authors.forename: Leocadio
authors.initials: L
authors.lastname: Rodríguez-Mañas
authors.affiliation: Department of Clinical Biochemistry, Virgen del Rocío University Hospital (IBiS/CSIC/SAS/University of Seville), Seville, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Medrano-Campillo
authors.affiliation: Division of Geriatric Medicine, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Spain.
authors.forename: María A
authors.initials: MA
authors.lastname: de la Torre Lanza
authors.affiliation: Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocio/CSIC/Universidad de Sevilla, Department of Medical Biochemistry and Molecular Biology and Immunology, University of Seville School of Medicine, Seville, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Alvarez-Sánchez
authors.affiliation: Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocio/CSIC/Universidad de Sevilla, Department of Medical Biochemistry and Molecular Biology and Immunology, University of Seville School of Medicine, Seville, Spain. Electronic address: vico@us.es.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carrillo-Vico
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001842:Bone and Bones / Q000378:metabolism*; D024042:Collagen Type I / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D006801:Humans; D010281:Parathyroid Hormone / Q000097:blood; D010446:Peptide Fragments / Q000097:blood*; D010455:Peptides / Q000097:blood; D011347:Procollagen / Q000097:blood*; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013223:Statistics as Topic; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D010281:Parathyroid Hormone; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide; D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: Bone markers; Frailty; PINP; PTH; Vitamin D