Metabolic reserve: baseline cholesterol as a predictor and modulator of response to in-hospital exercise in older adults.
Martín Beistegui-Sarobe, Chenhui Chenhuichen, Ana Zugasti-Murillo et al.
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In 30 seconds
This secondary analysis of a randomized controlled trial examined whether baseline nutritional biomarkers predicted functional response to multicomponent exercise among 303 hospitalized adults aged ≥75 years. Response was defined as an increase of ≥1 point in the Short Physical Performance Battery score from admission to discharge. In the exercise group, 85.3% were responders; their baseline cholesterol was higher than that of non-responders (148 vs. 126.5 mg/dL; p = 0.01). In the overall cohort, cholesterol interacted with exercise assignment (interaction OR 1.025 per mg/dL; 95% CI 1.008-1.041; p = 0.004).
Key findings
- Among exercise-group participants, 85.3% met the functional-response definition.
- Responders had higher baseline cholesterol than non-responders (148 vs. 126.5 mg/dL; p = 0.01); adjusted OR was 1.018 per mg/dL (95% CI 1.00-1.03; p = 0.014).
- Baseline cholesterol interacted with exercise assignment (interaction OR 1.025 per mg/dL; 95% CI 1.008-1.041; p = 0.004).
- Total serum protein also interacted with exercise assignment (interaction OR 3.17 per g/dL; 95% CI 1.16-8.66; p = 0.024).
Why it matters
Functional gains during acute hospitalization may vary with patients’ baseline physiological or nutritional reserves. These findings suggest that cholesterol and serum protein could help characterize variation in response to rehabilitation, while underscoring that biomarker associations do not establish why some patients improve more. Considering nutritional status alongside functional assessment may inform understanding of rehabilitation outcomes in older inpatients.
What to keep in mind
This was a secondary analysis of a randomized trial; the biomarker-response findings are predictive and interaction analyses, not randomized comparisons of nutritional status.