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S16
Oral presentations / European Geriatric Medicine 6S1 (2015) S5
–
S31
Metabolism and nutrition
O-039
IGF-1 as cross-road between nutritional and hormonal
pathways in hospitalized older adults: the GLISTEN study
M. Maggio
1
, F. Lauretani
2
, V. Giacomini
3
, R. Zucchelli
3
, G. Bondi
3
,
A. Fisichella
1
, M. Mantovani
1
, S. Masoni
1
, F. De Vita
1
, F. Corica
4
,
F. Landi
5
, L. Bianchi
6
, S. Volpato
7
, G.P. Ceda
6
1
University of Parma Dpt Clinical and Experimental Medicine, Parma,
Italy;
2
Geriatrics Unit, Parma University Hospital, Parma, Italy;
3
University-Hospital Parma, Parma, Italy;
4
University of Messina,
Messina, Italy;
5
Catholic University of Sacred Hearth, Rome, Italy;
6
Italy;
7
University of Ferrara, Italy, Ferrara, Italy
Insulin like growth factor-1 (IGF-1) is such a cross-road molecule
between hormonal and nutritional pathways being an important
anabolic hormonal determinant of muscle mass and acting
as nutritional marker in adults. We tested the hypothesized
positive relationship between IGF-1 and nutrition markers in older
hospitalized patients.
Methods:
We used data of the multicenter Italian Study conducted
by Gruppo Lavoro Italiano Sarcopenia – Trattamento e Nutrizione
(GLISTEN) in 7 acute Geriatric Wards of University-Hospitals across
Italy. We used here data of 77 women and 75 men hospitalized
between October 2013 and 2014 in Parma, Messina, Ferrara, and
Rome having serum available of patients at hospital admission and
with complete CGA at hospital admission and discharge. Estimation
of skeletal muscle mass was performed by bioelectrical impedance
analysis (BIA). IGF-1 was measured in BRAC, Boston, USA.The
relationship between IGF-1 and muscle mass and nutritional
marker, was tested by multivariate regression models including age
(Model 1) and age, IADL, cognitive and depressive status, multi-
morbidity, hemoglobin, and WBC (Model 2).
Results:
Mean Age
±
SD was 85
±
6.3 and 79.3
±
6.1 in women
and men. Medians (IQR) for IGF-1 were 64.7 (35.7) and
81.9 (48.9) ng/mL. In age-adjusted analysis log(IGF-1) was positively
associated with albumin in men (
b
±
SE 0.37
±
0.12, p = 0.003),and
women (0.40
±
0.14, p = 0.009). Log(IGF-1) was also positively
associated with reactance in men (7.56
±
4.12, p = 0.04) but not in
women (p = 0.46) at hospital admission. In Model 2 the association
between IGF-1 and albumin was attenuated but still statistically
significant in men (0.24
±
0.12, p = 0.049) and women (0.31
±
0.14,
p = 0.03). Interestingly, in the Model 2, the association between
IGF-1 and muscle reactance was even stronger in men (10.12
±
4.44,
p = 0.01) but not in women (p = 0.64).
Conclusions:
IGF-1 is an independent correlate of albumin in both
sexes and of reactance in men in older hospitalized population
enforcing its potential role as nutritional and anabolic marker also
in this setting.
O-040
Dementia, malnutrition, functional status and pressure ulcers:
an association analysis in hospitalized elderly with dementia
G. Fabio
1
, S. Perna
2
, F. Moncaglieri
2
, R. Pozzi
2
, V. Infantino
2
,
M. Naso
2
, F. Monteferraio
2
, F. Guerriero
2
, C. Sgarlata
2
, I. Degli
Agosti
3
, M. Rondanelli
2
1
Azienda di Servizi alla Persona, S. Margherita Institute, Pavia, Italy;
2
University of Pavia, Pavia, Italy;
3
ASP Pavia, Pavia
Objectives:
Pressure ulcers (PU) may increase the incidence of
hospital complications, specially in patients with mild impairment.
The Braden Scale primary stands out as a tool to assess the risk of
PU.
The aim of this study is assess the correlation among Brass Scale
with Mini Nutritional Assessment, Barthel Index and Mini Mental
State Examination.
Methods:
On 168 subjects (40m/128f; age 84
±
6.2 y), Pressure ulcer
risk using Braden Score (BS) (16.2
±
3.8 unit), Nutritional Status using
Mini Nutritional Assessment (MNA) (16.4
±
4.46 unit), Functional
Status using Barthel Index (BI) (33.0
±
2.4 unit), and Mental Status
using Mini Mental State Examination (22.2
±
6.1 mcUI/ml), were
measured. A Pearson’s correlation model, was applied to assess
and quantify the associations between MNA, BI, MMSE and the
Braden Index.
Results:
This study showed a positive and moderate significant
association among MNA (r = 0.31), MMSE (r = 0.48), BI (r = 0.81) with
BRASS Score (P
<
0.05).
Conclusions:
Accurate identification and prevention of the
risk factors such as malnutrition, disability and dementia, are
prerequisites for determining appropriate strategies to prevent
pressure ulcers, to improve quality of care for patient safety.
O-041
Serum retinol concentrations and risk of hip fracture in
community-dwelling older Norwegians. A NOREPOS study
K. Holvik
1
, L. Ahmed
2
, S. Forsmo
3
, C. Gjesdal
4
, G. Grimnes
5
,
S.O. Samuelsen
6
, B. Schei
3
, R. Blomhoff
7
, G.S. Tell
4
, H.E. Meyer
1
1
Norwegian Institute of Public Health, Oslo, Norway;
2
University
of Tromsø, Tromsø, Norway;
3
Norwegian University of Science and
Technology, Trondheim, Norway;
4
University of Bergen, Bergen,
Norway;
5
The Arctic University of Norway, Tromsø, Norway;
6
University of Oslo and Norwegian Institute of Public Health, Oslo,
Norway;
7
University of Oslo and Oslo University Hospital, Oslo,
Norway
Objectives:
Findings from earlier epidemiologic studies have led
to cautions against retinol from diet and supplements due to
an anticipated increased fracture risk at high intakes and serum
concentrations. We aimed to study the association between serum
retinol and hip fracture, and whether high retinol may counteract
a preventive effect of vitamin D.
Methods:
A prospective case-cohort analysis was conducted in
21,774 men and women aged 65–79 who attended four community-
based health studies during 1994–2001. Incident hip fractures
occurring up to 10.7 years after examination were obtained from
electronic hospital discharge registers. Retinol determined in stored
serum was available in n = 1154 incident hip fracture cases and in
a gender-stratified random sample (n = 1418).
Results:
In Cox proportional hazards regression weighted according
to the stratified case-cohort design, there was a modest increased
risk of hip fracture in the lowest compared to the highest tertile of
s-retinol: HR 1.30 (95% CI: 1.05, 1.61) adjusted for gender and study
center. The association was attenuated after adjustment for BMI
and serum
a
-tocopherol: HR 1.15 (95% CI: 0.91, 1.44). No statistical
interaction with 25-hydroxyvitamin D was observed.
Conclusions:
We found no evidence of an adverse effect of high
serum retinol on hip fracture, nor any interaction between retinol
and 25(OH)D. If anything, there tended to be an increased risk at
low retinol concentrations, which was attenuated after controlling
for confounders. We propose that cod liver oil, a commonly used
food supplement in Norway, should not be discouraged as a natural
source of vitamin D for fracture prevention.