title: Serum levels of C-terminal agrin fragment (CAF) are associated with sarcopenia in older multimorbid community-dwellers: Results from the ilSIRENTE study.
abstract: The C-terminal agrin fragment (CAF), a circulating byproduct of neuromuscular junction disassembly, has been proposed as a possible biomarker for sarcopenia. However, its validity in "real-world", multimorbid older persons is currently unknown. The present study was undertaken to verify if serum CAF levels were associated with sarcopenia in a population of old and very old persons living in the community.
  
  
  
  Data were from the ilSIRENTE Aging and Longevity Study, a prospective cohort study conducted in all persons aged 80years and older residing in the Sirente geographic area (Italy; n=332). The identification of sarcopenia was based on the criteria elaborated by the European Working Group on Sarcopenia in Older People (EWGSOP). Serum levels of CAF were determined using a commercial ELISA kit.
  
  
  
  Sarcopenia was identified in 101 participants (30.8%). Serum levels of CAF were significantly higher in older adults with sarcopenia compared with non-sarcopenic participants (96.99±5.40pmol/L vs. 76.54±2.15pmol/L; p<0.001). The association remained significant in both genders after adjustment for several possible confounding factors, including age, cognition, disability status, body mass index, congestive heart failure, lung diseases, diabetes, renal failure, and plasma levels of C-reactive protein and interleukin 6.
  
  
  
  Our results obtained from a fairly large sample of old and very old, multimorbid community-dwellers show that elevated serum CAF levels are associated with sarcopenia, independent of age, gender and several clinical, functional, anthropometric, and biochemical variables. The determination of serum CAF concentration may therefore be proposed as a simple screening test for sarcopenia in the community.
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: francesco.landi@rm.unicatt.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Landi
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Calvani
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Lorenzi
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Martone
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Tosato
authors.affiliation: Medizinische Klinik und Poliklinik IV, Schwerpunkt Akutgeriatrie, Klinikum der Universitat Munchen, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Drey
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: D'Angelo
authors.affiliation: Institute of Biochemistry and Clinical Biochemistry, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Capoluongo
authors.affiliation: Teaching Nursing Home "Opera Santa Maria della Pace", Fontecchio-Celano, L'Aquila, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Russo
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bernabei
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Graziano
authors.initials: G
authors.lastname: Onder
authors.affiliation: Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy. Electronic address: emarzetti@live.com.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Marzetti
mesh_terms: D000369:Aged, 80 and over; D000375:Aging / Q000097:blood; D018171:Agrin / Q000097:blood*; D000886:Anthropometry / Q000379:methods; D015415:Biomarkers / Q000097:blood; D005260:Female; D005684:Gait / Q000502:physiology; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D057187:Independent Living; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D055948:Sarcopenia / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology
chemical_list: D018171:Agrin; D015415:Biomarkers; C000602450:C-terminal agrin fragment; D010446:Peptide Fragments
keywords: Aging; Anthropometry; Biomarkers; Co-morbidity; Frailty; Functional impairment; Gait speed; Handgrip; Mid-arm muscle circumference; Muscle wasting; Neuromuscular junction; Physical performance; Renal failure; Skeletal muscle