Older adults (n = 600) aged 65–90 years were included in the study with equal numbers of men and women. Their mean BMI was normal and most of them were married, had schooling education, living with their families and were non-smokers. In addition, more older men were employed (P = 0∙04) and diabetic (P = 0∙05) whereas more women were hypertensive (Table 1).
P-value obtained from Independent Student t-test∙ *p < 0∙05, **p < 0∙001∙
§ Others included having more than one health problem and those with other diseases such as thyroid disorders, osteoporosis, gastrointestinal disorders, etc.∙
When compared with normal laboratory values, the study indicated that both older men and women had higher fasting blood glucose, glycated hemoglobin A1C, total serum cholesterol, C-reactive proteins levels and AIP. On the other hand, they had lower hemoglobin, serum iron, serum albumin and vitamin B12 levels (Table 2). Although these biochemical markers are elevated for the older participants, women had better values than their counterparts in some of these markers.
Table 2: Selected Biochemical markers for older Saudi men and women. Mean ± SD, normal and P-values are shown |
Blood Test | Women (n = 300) | Men (n = 300) | P-value | Normal values |
Fasting Blood Glucose (mmol/L) | 5∙77 ± 5∙76 | 6∙23 ± 4∙32 | 0∙40 | 4∙6–6∙4 |
Glycated Hemoglobin A1C (%) | 7∙90 ± 2∙95 | 8∙4 ± 1∙64 | < 0∙001** | 4∙3–6∙0 |
Hemoglobin level (g/dl) | 12∙6 ± 3∙46 | 12∙6 ± 3∙46 | 0∙27 | 12–16 |
Iron (µmol/L) | 7∙8 ± 9∙83 | 9∙8 ± 3∙73 | 0∙80 | 9∙0–30∙4 |
Ferritin ug/mL | 68∙12 ± 14∙705 | 39∙12 ± 12∙991 | < 0∙001** | 12 to 150 |
LDL-cholesterol (mmol/L) | 3∙23 ± 0∙86 | 2∙92 ± 1∙02 | 0∙87 | 5∙2–6∙1 |
HDL-cholesterol (mmol/L) | 1∙22 ± 0∙31 | 1∙02 ± 0∙19 | < 0∙001** | 1∙0 |
Total cholesterol (mmol/L) | 6∙78 ± 1∙14 | 6∙63 ± 1∙13 | 0∙04* | 5∙3–6∙2 |
Triglycerides (mmol/L) | 1∙27 ± 0∙67 | 1∙49 ± 1∙1 | < 0∙001** | 0∙40 − 1∙52 |
ALT (U/L) | 16 ± 2∙01 | 18 ± 4∙01 | 0∙01* | 7–55 |
AST (U/L) | 20∙0 ± 9∙18 | 19∙0 ± 6∙18 | 0∙06 | 15∙1–46∙2 |
Creatinine (mmol/L) | 57∙1 ± 9∙83 | 89∙1 ± 10∙33 | < 0∙001** | 45–90 |
C-reactive protein (mg/L) | 17∙14 ± 5∙92 | 36∙14 ± 7∙82 | 0∙003** | 0∙00–5∙00 |
AIP | 0∙21 ± 0∙18 | 0∙22 ± 0∙21 | 0∙04* | 0∙11 − 0∙21 |
Albumin (g/L) | 33∙0 ± 5∙21 | 37∙0 ± 7∙31 | 0∙02* | 35–55 |
Vitamin B12 (pmol/L) | 220∙0 ± 22∙80 | 215 ± 22∙78 | < 0∙05* | 118–701 |
P-value obtained from Independent Student t-test∙ *p < 0∙05, **p ≤ 0∙001∙ |
Results further revealed that more men (44%) than women (26∙4%) were either overweight and/or obese. On the contrary, hypoalbuminemia was more common among women (54%) than men (41%). Based on their AIP results, the prevalence of intermediate to high CVD risk amongst men was significantly higher than women (55% versus 94%, P = 0∙003). Men (57%) and women (33%) also had high C-reactive protein levels (Table 3).
Table 3: Categories of Body composition and selected biochemical markers amongst Saudi old men and women. Number and percentages are shown# |
| Women n (%) | Men n (%) |
BMI (Kg/m2) |
Underweight (< 18∙5) | 74 (24∙7) | 23 (7∙7) |
Normal weight (18∙5 to 25) | 149 (49∙7) | 125 (41∙7) |
Overweight (25 to 29∙9) | 68 (22∙7) | 110 (36∙7)* |
Obese (≥ 30) | 11 (2∙7) | 22 (7∙3) |
Albumin (g/L) |
< 35 | 163 (54∙3) | 122 (40∙7) |
35–50 | 126 (42∙0) | 177 (59∙0) |
> 50 | 9 (3∙0) | 1 (0∙3)* |
Hemoglobin (g/dl) |
F < 12 g/dl; M < 14 | 122 (40∙7) | 162 (54) |
F 12 to 16; M 14 to 18 | 176 (58∙7) | 135 (45) |
F > 16; M < 18 | 2 (0∙7) | 3 (1) |
Iron (µmol/L) |
F < 11; M < 14 | 201 (67∙0) | 253 (84∙3) |
F 11–29; M 14–32 | 90 (30∙0) | 49 (16∙3) |
F > 29; M > 32 | 9 (3∙0) | 0 (0)** |
Glycated hemoglobin A1C (%) |
Normal < 5∙7 | 60 (20∙0) | 17 (5∙7) |
Pre-diabetic 5∙7% to 6∙4 | 24 (8∙0) | 35 (11∙7) |
Diabetic > 6∙4 | 216 (72∙0) | 248 (82∙7)* |
Vitamin B12 (pmol/l) |
< 118 | 73 (24∙3) | 25 (8∙3)* |
118–701 | 211 (70∙3) | 251 (83∙7) |
> 701 | 16 (5∙3) | 24 (8) |
Atherogenic Index of Plasma (CVD risk) |
Low | 135 (45) | 18 (6∙0) |
Intermediate | 77 (25∙7) | 5 (1∙7)* |
High | 88 (29∙3) | 277 (92∙3)** |
C-reactive protein (mg/L) |
< 1∙00 mg/L | 50 (16∙6) | 20 (6∙7) |
1∙00–5∙00 mg/L | 150 (50∙0) | 110 (36∙7) |
> 5 mg/L | 100 (33∙4) | 170 (56∙6)* |
#Total number of women (300) and men (300); P-value obtained from One-way ANOVA∙ *P < 0∙05; **p < 0∙001 |
Moreover, both older men and women with high CVD risk based on AIP, had significantly elevated fasting blood glucose (women only), glycated hemoglobin A1C, LDL-C, total cholesterol, triglycerides, C-reactive protein, serum iron (women only) and albumin levels as well as were obese (Supplementary Table 1). Furthermore, using Pearson's correlation, high CVD risk based on their AIP associated positively with triglycerides (r = 0∙76, P = 0∙003), total cholesterol (men only: r = 0∙56, P = 0∙02), LDL-C (men only: r = 0∙62, P = 0∙001), C-reactive proteins (r = 0∙50, P = 0∙03) and BMI (women only: r = 0∙81, P = 0∙002). In addition, high AIP correlated negatively with albumin levels (r = -0∙62, P = 0∙01) and HDL-C (men only: r= -0∙57, P = 0∙05). Results not shown on Table.
Multivariate analysis based on the Multiple Regression in which age was the dependent variable and the biochemical markers, AIP and BMI were the independent variables revealed higher significant odds for BMI, triglycerides, C-reactive protein, and AIP (Supplementary Table 2).