Kritchevsky Stephen B, Nicklas Barbara J, Visser Marjolein, Simonsick Eleanor M, Newman Anne B, Harris Tamara B, Lange Ethan M, Penninx Brenda W, Goodpaster Bret H, Satterfield Suzanne, Colbert Lisa H, Rubin Susan M, Pahor Marco
The Sticht Center on Aging and Center for Human Genomics, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
JAMA. 2005 Aug 10;294(6):691-8. doi: 10.1001/jama.294.6.691.
Physical performance in response to exercise appears to be influenced by the angiotensin-converting enzyme (ACE) insertion (I)/deletion (D) genotype in young adults, but whether this relationship could help explain variation in older individuals' response to exercise has not been well studied.
To determine whether the ACE genotype interacts with significant physical activity to affect the incidence of mobility limitation in well-functioning older adults.
DESIGN, SETTING, AND PARTICIPANTS: The Health Aging and Body Composition (Health ABC) Cohort Study, conducted in the metropolitan areas of Memphis, Tenn, and Pittsburgh, Pa. A total of 3075 well-functioning community-dwelling adults aged 70 through 79 years were enrolled from 1997 to 1998 and had a mean of 4.1 years of follow-up.
Incident mobility limitation defined as the report of difficulty walking a quarter of a mile (0.4 km) or walking up 10 steps on 2 consecutive semiannual interviews (n = 1204).
Physically active participants (those reporting expending > or =1000 kcal/wk in exercise, walking, and stair climbing) were less likely to develop mobility limitation regardless of genotype. However, activity level interacted significantly with the ACE genotype (P = .002). In the inactive group, the ACE genotype was not associated with limitation (P = .46). In the active group, those with the II genotype were more likely to develop mobility limitation after adjusting for potential confounders compared with those with ID/DD genotypes (adjusted rate ratio, 1.45, 95% confidence interval, 1.08-1.94). The gene association was especially strong among participants reporting weightlifting. Exploration of possible physiological correlates revealed that among active participants, those with the II genotype had higher percentage of body fat (P = .02) and more intermuscular thigh fat (P = .02) but had similar quadriceps strength as those with ID/DD.
Among older individuals who exercised, those with the ACE DD or ID genotypes were less likely to develop mobility limitation than those with the II genotype. Regardless of genotype, individuals who exercised were less likely to develop mobility limitation than those who did not exercise.
年轻人运动时的身体表现似乎受血管紧张素转换酶（ACE）插入（I）/缺失（D）基因型的影响，但这种关系能否解释老年人运动反应的差异尚未得到充分研究。
确定ACE基因型是否与大量体育活动相互作用，从而影响功能良好的老年人出现行动能力受限的发生率。
设计、地点和参与者：健康老龄化与身体成分（Health ABC）队列研究，在田纳西州孟菲斯市和宾夕法尼亚州匹兹堡市的大都市地区进行。1997年至1998年共招募了3075名功能良好的70至79岁社区居住成年人，平均随访4.1年。
行动能力受限事件定义为在连续两次半年访谈中报告行走四分之一英里（0.4公里）困难或上10级台阶困难（n = 1204）。
无论基因型如何，身体活跃的参与者（即报告每周在运动、步行和爬楼梯中消耗≥1000千卡热量的人）出现行动能力受限的可能性较小。然而，活动水平与ACE基因型存在显著交互作用（P = 0.002）。在不活跃组中，ACE基因型与行动能力受限无关（P = 0.46）。在活跃组中，与ID/DD基因型者相比，调整潜在混杂因素后，II基因型者出现行动能力受限的可能性更大（调整后的率比为1.45，95%置信区间为1.08 - 1.94）。这种基因关联在报告举重的参与者中尤为明显。对可能的生理相关因素的探索表明，在活跃参与者中，II基因型者的体脂百分比更高（P = 0.02），大腿肌间脂肪更多（P = 0.02），但股四头肌力量与ID/DD基因型者相似。
在进行运动的老年人中，ACE DD或ID基因型者比II基因型者出现行动能力受限的可能性更小。无论基因型如何，运动的人比不运动的人出现行动能力受限的可能性更小。
