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Angela Marie Abbatecola, MD; Luigi Ferrucci, PhD; Raffaele Marfella, MD; Giuseppe Paolisso, MD

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In the April, 2007, issue of the Archives, Barzilay et al¹ reported that 2 components of the metabolic syndrome, insulin resistance (IR) and inflammation, are associated with the risk of frailty in older persons with out diabetes mellitus, severe cognitive impairment, or other chronic illnesses. Using the homeostasis model of assessment (HOMA), they found that IR and C-reactive protein were consistently associated with an increased risk of developing frailty, even after adjusting for confounders. The authors propose that there is a causative relationship between IR and frailty. Specifically, they propose that the progressive age-associated decline of insulin sensitivity causes an imbalance toward catabolism, which is clinically expressed as an accelerated decline of muscle mass and strength. Such findings further substantiate previous findings from the "Invecchiare in Chianti" (InCHIANTI) study showing that IR-HOMA score was independently associated . . . [Full Text of this Article]

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