Y. Zhu, Z. Liu, Y. Wang, Z. Wang, J. Shi, X. Xie, L. Jin, X. Chu, X. Wang
Arch Gerontol Geriatr. 2016;64:1-5
C-reactive protein (CRP), an important inflammatory biomarker, has been linked to various diseases (e.g., cardiovascular disease). This paper aimed to investigate the associations of high sensitivity C-reactive protein (hsCRP) with frailty and overnight hospital admission in an elderly Chinese population.
Cross-sectional data from 1478 participants (aged 70-84 years) who were randomly recruited from 31 villages in Jiang'an township, Rugao city, China were used. Frailty status was defined using a modified frailty phenotype. The number of overnight hospital admissions was ascertained.
The sample mean age was 75.3 years, and 53.0% of participants were female (n=784). The mean level of hsCRP was 3.6mg/L. From the low (hsCRP≤1.00mg/L) to high hsCRP (hsCRP≥3.0mg/L) group, the proportion of overnight hospital admission increased linearly (8.7%, 10.6%, vs. 15.5%; P for trend=0.007). For frailty, the age- and sex-adjusted odds ratios (ORs) were 1.21 (95% CI: 0.89, 1.64) for participants in the intermediate hsCRP group and 1.49 (95% CI: 1.05, 2.09) for participants in the high hsCRP group compared with those in the low hsCRP group. For overnight hospital admission, the corresponding ORs were 1.26 (95% CI: 0.72, 2.19) and 1.94 (95% CI: 1.08, 3.48), respectively. After adjustment for other covariates, the significance of these associations remained.
It can be concluded that elevated levels of hsCRP were associated with increased risks of frailty and overnight hospital admission among elderly individuals in Rugao.
Comment: Despite of the cross-sectional design nature, this study provides preliminary but crucial evidence for future exploration of potential targeted interventions for the elderly. The association of hsCRP with frailty might be attributed to systemic inflammation. Notably, in this study, for the first time, a positive correlation between hsCRP and overnight hospital admission was observed. Summary score of inflammation biomarkers (including CRP) had been developed and used to predict outcomes such as hospitalizations, but the independent effect of CRP on hospital admission was not previously explored. Further studies are needed to verify our initial cross-sectional findings, and more public health concerns about inflammation and subsequent outcomes are also needed to improve the quality of life in elderly populations.