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Related Concept Videos

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
300
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

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Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
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Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

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Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
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Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

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As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
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Related Experiment Video

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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Uric acid and endothelial function in elderly community-dwelling subjects.

Andrea Ticinesi1, Fulvio Lauretani1, Gian Paolo Ceda1

  • 1Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.

Experimental Gerontology
|January 7, 2017
PubMed
Summary

Serum uric acid (SUA) is linked to endothelial function (EF) in older adults, particularly women. However, this association diminishes when considering factors like body mass index and trunk fat, suggesting SUA may be a metabolic marker, not a direct cause.

Keywords:
AgingEndotheliumMetabolismNitric oxideVasodilation

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Area of Science:

  • Gerontology and Cardiovascular Health
  • Vascular Biology and Endothelial Function
  • Metabolic Syndrome and Inflammation

Background:

  • Serum uric acid (SUA) is implicated as an inflammatory agent and potential mediator of cardiovascular diseases.
  • Previous research on SUA's role in endothelial function (EF) has been limited to middle-aged individuals with specific health conditions.
  • The relationship between SUA and EF in healthy elderly populations remains under-investigated.

Purpose of the Study:

  • To investigate the association between serum uric acid (SUA) levels and measures of endothelial function (EF) in a cohort of elderly community-dwelling individuals.
  • To explore potential gender differences in the relationship between SUA and EF.
  • To identify confounding factors, such as cardiovascular risk factors, hormonal mediators, and body composition, that may influence the SUA-EF relationship.

Main Methods:

  • The study analyzed data from 848 elderly participants (424 males, 426 females) aged 70 years from the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS).
  • Endothelial function (EF) was assessed using flow-mediated dilation (FMD), endothelium-dependent vasodilation (EDV) via acetylcholine infusion, and endothelium-independent vasodilation (EIDV) via sodium nitroprusside infusion.
  • Univariate and multivariate regression models, including backward selection from fully-adjusted models, were employed to analyze the relationship between SUA and EF measures, considering various confounders.

Main Results:

  • In univariate analyses, SUA showed an inverse association with both EDV and EIDV in both genders, but not with FMD.
  • After adjusting for body mass index (BMI), the association between SUA and EIDV persisted in females, though attenuated.
  • In the fully-adjusted multivariate model, including waist-to-hip ratio, the association between SUA and EIDV was no longer significant, indicating that confounders explain the relationship.

Conclusions:

  • In elderly individuals, particularly women, the association between serum uric acid (SUA) and endothelial function (EF) is not independent of confounding factors like BMI and trunk fat mass.
  • These findings suggest that SUA may act as a surrogate marker for metabolic health rather than an active player directly influencing endothelial function in older adults.
  • Further research is needed to elucidate the precise role of SUA in vascular health across different age groups and in the presence of various metabolic conditions.