Positive and negative inflammatory markers for falls and sarcopaenia in the Malaysian Elders Longitudinal Research study - A five-year prospective study

Aims: To evaluate the relationship between high- sensitivity C- reactive protein (hsCRP) and 25- hydroxyvitamin D (25(OH)D) with falls and sarcopaenia in older adults. Methods: Telephone follow- up data was available for 799 individuals aged ≥ 55 years from the Malaysian Elders Longitudinal Research (MELoR) study. Sociodemographic, health and biochemical data were obtained from 2013- 2015. Falls over the past 12 months and sarcopaenia using the SARC- F questionnaire were established at five years follow- up. Logistic regression analysis were conducted using cut- offs of low risk <1.0 and high risk >3.0, and 60 nmol/L for hsCRP and 25(OH)D respectively. Mediation analysis was conducted. Results: Mean age of participants was 68.2 ± 7.2 years, 57% women. Individuals with hsCRP > 3.0 were at in-creased risk of sarcopaenia compared to hsCRP <1.0 [OR (95% CI) = 2.30 (1.34- 3.96)]. The association remained significant after adjustment with baseline age, gender, ethnicity (Chinese versus non- Chinese), body mass index category, co- morbidities and 25(OH)D level [1.97 (1.09- 3.55)]. 25(OH)D<60 nmol/L was associated with sarcopenia [1.62 (1.06- 2.48)]. HsCRP > 3.0 was not associated with falls compared to hsCRP<1.0 [1.16 (0.75- 1.80)], while 25(OH)D<60 nmol/L was associated with falls [1.53 (1.06- 2.23)]. 25(OH)D was a mediator of the relationship between obesity and sarcopaenia. Conclusions: HsCRP is a positive inflammatory marker while 25(OH)D is a negative inflammatory marker. While both high hsCRP and low 25(OH)D were associated with sarcopaenia, only low 25(OH)D was associated with falls. Future studies should seek to determine whether obesity interventions would reduce sarcopaenia and the role of 25(OH)D as biomarker.