Kritchevsky Stephen B, Cesari Matteo, Pahor Marco
Sticht Center on Aging, Section of Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Medical Center Boulevard, Winston Salem, NC 27157, USA.
Cardiovasc Res. 2005 May 1;66(2):265-75. doi: 10.1016/j.cardiores.2004.12.026. Epub 2005 Jan 28.
In the past decade inflammatory markers have emerged as strong independent risk indicators for cardiovascular disease. Even though adults over the age of 65 experience a high proportion of such events, most epidemiologic data are from middle-aged populations. In this review we examine the role that inflammatory markers play in the prediction of incident cardiovascular disease specifically in older adults. In studies of adults < 65 years, IL-6, TNFalpha and IL-10 levels have been shown to predict cardiovascular outcomes. The data on C-reactive protein are inconsistent, but CRP levels appear to be less useful in old-age than in middle-age. Fibrinogen levels predict mortality but in a non-specific manner. In the elderly inflammatory markers are non-specific measures of health and predict both disability and mortality even in the absence of clinical cardiovascular disease. Thus it is possible that, in older age-groups, interventions designed to prevent cardiovascular disease through the modulation of inflammation would also be helpful in reducing disability and mortality.
在过去十年中，炎症标志物已成为心血管疾病强有力的独立风险指标。尽管65岁以上的成年人此类事件发生率很高，但大多数流行病学数据来自中年人群。在本综述中，我们研究炎症标志物在预测心血管疾病发病方面所起的作用，特别是在老年人中。在对65岁以下成年人的研究中，白细胞介素-6（IL-6）、肿瘤坏死因子α（TNFα）和白细胞介素-10（IL-10）水平已被证明可预测心血管疾病结局。关于C反应蛋白（CRP）的数据并不一致，但CRP水平在老年人群中似乎比中年人群中作用更小。纤维蛋白原水平可预测死亡率，但方式并不特异。在老年人中，炎症标志物是健康状况的非特异性指标，即使在没有临床心血管疾病的情况下也能预测残疾和死亡率。因此，在老年人群中，通过调节炎症来预防心血管疾病的干预措施可能也有助于降低残疾率和死亡率。
