McDermott Mary M, Liu Kiang, Guralnik Jack M, Ferrucci Luigi, Green David, Greenland Philip, Tian Lu, Criqui Michael H, Lo Carol, Rifai Nader, Ridker Paul M, Zheng Jane, Pearce William
Northwestern University's Feinberg School of Medicine, Chicago, Illinois, USA.
J Gerontol A Biol Sci Med Sci. 2006 Apr;61(4):374-9. doi: 10.1093/gerona/61.4.374.
Inflammation may be a potential mechanism of aging-related functional decline. We determined whether greater annual increases in levels of high sensitivity C-reactive protein (hsCRP) and D-dimer predicted greater decline in functioning among persons with and without lower extremity peripheral arterial disease (PAD).
We prospectively studied 296 men and women with PAD and 191 without PAD. Objective measures of functioning, hsCRP, and D-dimer were obtained at baseline and annually for 3 years (mean follow-up = 36.3 +/- 6.4 months).
Among PAD participants, greater annual increases in hsCRP were associated with greater annual declines in 6-minute walk performance (-2.63 ft/mg/L, p =.039) but not in other functional outcomes. Higher prior year absolute hsCRP levels were associated with greater declines in 6-minute walk (-2.93 ft/mg/L, p =.022), summary performance score (-0.038/mg/L, p =.017), and rapid paced 4-meter walk (-0.29 cm/s/mg/L, p =.026) during the subsequent year. Among participants without PAD, greater annual increases in hsCRP were associated with greater annual declines in 6-minute walk (-7.47 ft/mg/L, p =.002), usual-pace 4-meter walk (-0.33 cm/s/mg/L, p <.001), fast paced 4-meter walk (-0.56 cm/s/mg/L, p =.003), and the summary performance score (-0.029 mg/L, p <.001). There were no consistent associations between D-dimer levels and functional decline.
These findings suggest that inflammation may play a role in functional decline in persons with and without PAD.
炎症可能是衰老相关功能衰退的潜在机制。我们确定了高敏C反应蛋白（hsCRP）和D-二聚体水平的年度增幅更大是否预示着有或没有下肢外周动脉疾病（PAD）的人群功能衰退更严重。
我们对296名患有PAD的男性和女性以及191名未患PAD的男性和女性进行了前瞻性研究。在基线时以及之后3年每年获取功能、hsCRP和D-二聚体的客观测量值（平均随访时间 = 36.3 ± 6.4个月）。
在患有PAD的参与者中，hsCRP的年度增幅更大与6分钟步行表现的年度下降幅度更大相关（-2.63英尺/毫克/升，p = 0.039），但与其他功能结局无关。前一年较高的hsCRP绝对水平与随后一年6分钟步行的下降幅度更大相关（-2.93英尺/毫克/升，p = 0.022）、综合表现评分下降幅度更大相关（-0.038/毫克/升，p = 0.017）以及快速4米步行下降幅度更大相关（-0.29厘米/秒/毫克/升，p = 0.026）。在未患PAD的参与者中，hsCRP的年度增幅更大与6分钟步行的年度下降幅度更大相关（-7.47英尺/毫克/升，p = 0.002）、平常步速4米步行下降幅度更大相关（-0.33厘米/秒/毫克/升，p < 0.001）、快速4米步行下降幅度更大相关（-0.56厘米/秒/毫克/升，p = 0.003）以及综合表现评分下降幅度更大相关（-0.029毫克/升，p < 0.001）。D-二聚体水平与功能衰退之间没有一致的关联。
这些发现表明炎症可能在有或没有PAD的人群的功能衰退中起作用。
