Apelin in obese frail elderly in out patient clinic in Zagazig University.

Background: Obesity exacerbates the age-related decline in physical function and causes frailty in older individuals. Frailty in older obese individuals may be related to the insulin resistance and inflammation that often associated with obesity. Obesity characterized by excess body fat which secretes adipokines hormones. Apelin is one of the adipokines directly regulated by insulin and body mass index (BMI), the present study was aimed to estimate serum apelin in elderly and investigate possible correlations between serum apelin, obesity-related markers and frailty phenotypic criteria. Subjects and methods: A case- control study included 74 lean elderly and 74 obese elderly patients who were stratified according to their body mass index (BMI) to three subgroup, In all studied participants we determined BMI, waist circumference, hip circumference, waist to hip ratio , mid upper arm circumference (MAC), self-reported exhaustion, low energy expenditure, chair-stand test s, 4-m walking time s, frailty index, max. grip strength (kg) for men and women, assessment of fat mass(FM) and fat free mass (FFM)using CT and Serum apelin levels were determined with an enzyme-linked immunosorbent assay, Result: All obesity group subjects had significantly higher values of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), BMI , fat mass , fasting blood glucose, fasting serum insulin, HOMA-IR, systolic and diastolic blood pressure (P<0.05) than lean subjects. diabetic obese group had significantly higher LDL-C, TC, TG, fasting blood glucose, fasting serum insulin, HOMA-IR, systolic and diastolic blood pressure than non-diabetic group, serum apelin levels were significantly higher in obese groups compared to control (P= ?0.05), and correlated positively with BMI, and fat mass, fasting insulin, HOMA-IR and triglycerides .In obese subjects, Self-reported exhaustion, low energy expenditure, Chair-stand test s, 4-m walking time s, frailty index, Max. grip strength (kg) for men and women were significantly associated with obesity and serum apelin. Conclusion:-We found that serum apelin and phenotype parameters of frailty were higher in obese than lean elderly. In obese group, serum apelin and phenotype parameters of frailty positively correlated with HbA1c values, fasting blood glucose, fasting serum insulin, HOMA-IR, LDL ,TG, BMI and fat mass.