The relationship between frailty and serum alpha klotho levels in geriatric patients
ARCHIVES OF GERONTOLOGY AND GERIATRICS
Authors: Polat, Yasemin; Yalcin, Ahmet; Yazihan, Nuray; Bahsi, Remzi; Surmeli, Deniz Mut; Akdas, Sevginur; Aras, Sevgi; Varli, Murat
Abstract
Background: Frailty is a medical syndrome resulting in loss of endurance, strength and physiological function. There is insufficient data to understand the process of frailty formation at the gene level, however one of the product of Klotho gene known as an anti-aging gene with many functions that prolong lifespan is alpha klotho protein. We aimed to investigate the relationship between frailty and the serum alpha klotho protein levels. Methods: In this cross-sectional analysis, there were 89 patients aged 65 years old and older, 45 of whom were frail and 44 of whom were not frail, were included in the study. Within the scope of the study, a sociodemographic and clinical information form, the Turkish version of the FRAIL scale and a comprehensive geriatric assessment were evaluated. In addition to routine laboratory tests, plasma alpha klotho protein levels were measured. Results: The mean alpha klotho protein levels of the patients were 0.76 +/- 1.01 ng/ml in the control group and 0.54 +/- 0.61 ng/ml in the frail group, however, there was no statistically significant difference between the two groups (p = 0.286). C-reactive protein (CRP) levels were significantly higher and hemoglobin (Hb) levels were significantly lower in the frail patients compared to the control group (p < 0.05). It was observed that alpha klotho protein level was inversly correlated with increased CRP levels but association was weak (p = 0.022, R: -0.245). Hb levels (p = 0.018, R: 0.250) was weakly correlated with alpha klotho protein level. Conclusion: No significant relationship was found between frailty and alpha klotho protein levels in the geriatric patients. Further comprehensive studies are needed to explore this subject.
Association of Biomarker Cutoffs and Endoscopic Outcomes in Crohn's Disease: A Post Hoc Analysis From the CALM Study
INFLAMMATORY BOWEL DISEASES
Authors: Reinisch, Walter; Panaccione, Remo; Bossuyt, Peter; Baert, Filip; Armuzzi, Alessandro; Hebuterne, Xavier; Travis, Simon; Danese, Silvio; Sandborn, William J.; Schreiber, Stefan; Berg, Sofie; Zhou, Qian; Kligys, Kristina; Neimark, Ezequiel; Suleiman, Ahmed A.; D'Haens, Geert; Colombel, Jean-Frederic
Abstract
Background CALM was a randomized phase 3 trial in patients with Crohn's disease (CD) that demonstrated improved endoscopic outcomes when treatment was escalated based on cutoffs for inflammatory biomarkers, fecal calprotectin (FC), C-reactive protein (CRP), and CD Activity Index (CDAI) remission vs CDAI response alone. The purpose of this post hoc analysis of CALM was to identify drivers of treatment escalation and evaluate the association between biomarker cutoff concentrations and endoscopic end points. Methods The proportion of patients achieving CD Endoscopic Index of Severity (CDEIS) <4 and no deep ulcers 48 weeks after randomization was evaluated according to CRP <5 mg/L or >= 5 mg/L and FC <250 mu g/g or >= 250 mu g/g. Subgroup analyses were performed according to disease location, and sensitivity analyses were conducted in patients with elevated CRP and/or FC at baseline. The association between endoscopic end points and biomarker cutoffs was performed using chi(2) test. Results The proportion of patients who achieved the primary end point CDEIS <4 and no deep ulcers was significantly greater for those with FC <250 mu g/g (74%; P < 0.001), with an additive effect for CRP <5 mg/L. The association of FC <250 mu g/g with improved endoscopic outcomes was independent of disease location, although the greatest association was observed for ileocolonic disease. Fecal calprotectin <250 mu g/g, CRP <5 mg/L, and CDAI <150 gave a sensitivity/specificity of 72%/63% and positive/negative predictive values of 86%/42% for CDEIS <4 and no deep ulcers 48 weeks after randomization. Conclusion This post hoc analysis of CALM demonstrated that a cutoff of FC <250 mu g/g is a useful surrogate marker for mucosal healing in CD.