Clinical significance of serum irisin, 25(OH)D3 and albumin in older adults with chronic disease and sarcopenia

Abstract

Background: Sarcopenia, characterized by progressive muscle mass and strength decline, poses a significant health challenge among older adults, especially those with chronic diseases. Our study aims to evaluate the combined diagnostic potential of irisin, 25(OH)D3, and albumin for sarcopenia in older patients with chronic conditions.

Methods: A cohort of 393 older patients with chronic diseases, including 117 diagnosed with sarcopenia were included. Fasting blood samples were collected, and serum biomarkers (25(OH)D3, albumin, and irisin) were measured using automated biochemical analyzers and enzyme-linked immunosorbent assay to evaluate nutritional and muscle-related parameters.

Results: The prevalence of sarcopenia was higher among patients aged 80 or older compared to younger age groups in our study population. Strong associations were observed between sarcopenia and osteoporosis, tumors, and risk of malnutrition. Serum irisin, 25(OH)D3, and albumin levels were significantly lower in sarcopenic patients. Individual biomarkers displayed diagnostic potential, and a combined biomarker test showed superior accuracy. Multivariate logistic regression identified age, osteoporosis, malnutrition, and fatigue as independent risk factors, while higher serum biomarker levels correlated with reduced sarcopenia risk. Positive correlations were observed between serum biomarkers and sarcopenia severity indicators.

Conclusions: This study highlights the potential of irisin, 25(OH)D3, and albumin as diagnostic and prognostic tools for sarcopenia in older patients with chronic diseases, contributing to early detection and intervention strategies to enhance their quality of life.

Keywords: 25(OH)D3; Albumin; Irisin; Older adults; Sarcopenia.

Fig. 1

Comparative analysis of serum biomarker levels between older chronic disease patients with or without sarcopenia. The violin plots depict the distribution and median values of serum irisin (a), 25-hydroxyvitamin D3 (25(OH)D3) (b), and albumin (c). Statistically significant lower levels of these biomarkers are evident in the sarcopenic group (SP), as compared to the non-sarcopenic group (NSP), with p-values < 0.001 obtained from an unpaired t-test with Welch’s correction, indicating a strong association between reduced levels of these biomarkers and the presence of sarcopenia in this population

Fig. 2

Receiver Operating Characteristic (ROC) analysis for sarcopenia biomarkers. The ROC curves illustrating the diagnostic efficacy of serum biomarkers—irisin, 25(OH)D3, albumin, and their combined form (‘Union’) for identifying sarcopenia in older patients with chronic diseases in older patients with chronic diseases. The union test formula is- 0.042Irisin − 0.05125(OH)D3–0.087Albumin. The curves demonstrate the diagnostic capability of each biomarker alone and in combination to differentiate between sarcopenic (SP) and non-sarcopenic (NSP) states.

Fig. 3

Correlation Analysis between ASMI and Serum Biomarkers in Sarcopenic Patients. The results of a Spearman correlation coefficient analysis between appendicular skeletal mass index (ASMI) and serum biomarkers in a cohort of 117 older patients with chronic diseases and diagnosed with sarcopenia. The correlation of ASMI with serum irisin (a), serum 25(OH)D3 levels (b), and serum albumin levels

Fig. 4

Correlation analysis between grip strength and serum biomarkers in sarcopenic patients. The Spearman correlation coefficient analysis illustrating the association between grip strength and serum biomarkers in 117 older chronic disease patients with sarcopenia. The grip strength in relation to serum irisin levels (a), serum 25(OH)D3 levels (b), and serum albumin levels (c)