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Poster presentations / European Geriatric Medicine 6S1 (2015) S32
–
S156
S45
Design:
A longitudinal twin study with baseline and follow-up
measurements of LTL and insulin resistance (HOMA-IR) over an
average follow-up of 12 years.
Setting:
A subset of the population-based national Danish Twin
Registry
Participants:
338 twin pairs of the same sex (184 MZ and 154 DZ)
aged 37.4
±
9.6 years at baseline examination.
Main outcome measure:
Relationship between LTL and HOMA-IR
and changes in both measurements during the follow up period.
Results:
Baseline HOMA-IR was not associated with changes in
LTL (attrition) over the follow up period, whereas baseline LTL
was associated with changes in HOMA-IR during this period. The
shorter the LTL at baseline the more pronounced was the increase
in HOMA-IR over the follow-up period (p
<
0.001); this effect was
additive to that of BMI. The co-twin with the shorter baseline LTL
displayed a higher HOMA-IR at follow-up than the co-twin with
the longer LTL. A larger difference in LTL between the co-twins
at baseline was associated with a greater probability that the co-
twin with the shorter LTL would develop a higher HOMA-IR at
follow-up.
Conclusion:
These findings suggest that individuals with short LTL
are more likely to develop insulin resistance later in life.
P-050
Independent predictors of hospital admission in emergency
department patients younger and older than 70 years of age
J. Lucke
1
, J. de Gelder
2
, B. de Groot
1
, F. Clarijs
2
, C. Heringhaus
1
,
A.J. Fogteloo
1
, G. Blauw
3
, S. Mooijaart
3
1
Leiden University Medical Centre, Leiden, Netherlands;
2
LUMC,
Leiden, Netherlands;
3
Netherlands
Introduction:
Independent predictors of hospital admission have
been investigated in patients on the Emergency Department (ED),
but it is unknown whether these predictors are different for
patients above and below 70 years old. In this study we compared
patient characteristics between patients younger and older than 70
years and investigated whether independent predictors of hospital
admission are different in these patient groups.
Method:
A retrospective cohort study of all ED visits in a tertiary
hospital in 2012. Patient characteristics including way of arrival,
presenting complaint and urgency of the complaint were analysed
and stratified into age groups. Multivariable logistic regression
was used to identify independent predictors and discriminative
performance was quantified by area under the curve (AUC) analysis
in both groups.
Results:
4255 patients
>
70 years and 17319 patients
<
70 years were
included. 45% of the older patients were hospitalized and 25% of
the younger patients. Between age groups the same independent
predictors were found such as triage category and amount of
registered vital parameters, mostly reflecting illness severity. The
prediction model for hospitalisation had a higher discriminative
performance in young patients with an AUC of 0.85 (0.84–0.85),
the model in old patients had an AUC of 0.76 (0.75–0.78), with
both models having good predicting capabilities.
Conclusion:
Independent predictors of hospital admission are
similar in patients younger and older than 70 years in the ED,
but perform better in younger patients. This suggests that in older
patients other factors such as cognition and functional status, may
play a role.
P-051
Leukocyte telomere length is associated with lean mass: data
from the Berlin Aging Study II (BASE-II)
A. Meyer
1
, B. Salewsky
2
, E. Steinhagen-Thiessen
3
, K. Norman
3
,
I. Demuth
2
1
Charit´e-Universit¨atsmedizin Berlin, Berlin, Germany;
2
Institute
of Medical and Human Genetics, Charit´e-Universit¨atsmedizin
Berlin, Berlin, Germany;
3
Research Group on Geriatrics, Charit´e-
Universit¨atsmedizin Berlin, Berlin, Germany
Background:
Age-related loss of muscle mass is an increasing
problem in in our aging society, affecting physical ability. Telomere
length has been recognized as a marker of biological age on the
population level.
Objective:
Here we evaluated the rarely examined relationship
between lean mass and relative leukocyte telomere length (rLTL) in
1,398 participants of the Berlin Aging Study II (mean age 68.2
±
3.7
years, 49.6% men).
Methods:
The determination of rLTL was carried out by real time
PCR. Lean mass was estimated by dual X-ray absorptiometry and
examined as leg lean mass (LLM), appendicular lean mass (ALM),
and ALM corrected for body mass index (ALMBMI).
Results:
Highly significant correlations (p
<
0.001) of rLTL and
ALM (r = 0.248), ALMBMI (r = 0.254), and LLM (r = 0.263) were
found. Associations remained significant in linear models adjusted
for age, gender, BMI, low-grade inflammation, life style factors
and morbidities: ALM (
b
= 0.844, p = 0.009), ALMBMI (
b
= 0.032,
p = 0.011), and LLM (
b
= 0.967, p
<
0.001). Shorter rLTL, advanced
age, female sex, sedentary lifestyle and elevated CRP level were
associated with lower lean mass.
Conclusion:
Short telomeres were associated with low lean mass.
Our results indicate that rLTL may be a risk factor for loss of
lean mass. To confirm the association between telomere attrition
and loss of LLM and ALMBMI, which are highly relevant for
physical ability, further research should examine this subject in
a longitudinal context.
P-052
Loss of fertility in aging males due to increased testicular
estradiol production
A. Rosenstrauch
1
, A. Degen
2
1
Achva Academic College, Shikmim, Israel;
2
Ben-Gurion University,
Beer Sheva, Israel
In aging man, other mammals and birds, loss of fertility is
accompanied by high levels of plasma estradiol and concomitant
reduced levels of both plasma LH and testosterone. Hormonal
levels are regulated by the negative feedback mechanism as
follows: (1) plasma testosterone is aromatized to estradiol in
the brain, (2) which attaches to hypothalamic estradiol-receptors;
(3) the estradiol-receptor complex results in the reduction of
GnRH secretion (4) that leads to decrease in plasma LH and FSH
levels and the consequent reduction of testicular testosterone level.
We examined fertility changes in the aging rooster, an animal
that reaches peak fertility at a relatively young age. In addition,
we examined fertility changes in aging roosters treated with
clomiphene citrate, an anti-estrogen.
We collected pituitary glands of high fertility (32 weeks), and aged
roosters (70 weeks) with and without clomiphene citrate treatment
to determine number of gonadotrophs in the pituitary. In addition,
plasma, LH, testosterone and 17
b
-estradiol were measured using
radioimmunoassays.
In 70 week old males, the number of gonadotrophs per mm
2
,
plasma LH concentrations and plasma testosterone concentrations
were reduced by 56%, 39% and 40%, respectively, when compared
to 32 week old roosters. However, the clomiphene citrate treated
males had similar measurements as the 32 week old roosters.