Jylhä Marja, Paavilainen Paula, Lehtimäki Terho, Goebeler Sirkka, Karhunen Pekka J, Hervonen Antti, Hurme Mikko
Tampere School of Public Health, FIN-33014 University of Tampere, Finland.
J Gerontol A Biol Sci Med Sci. 2007 Sep;62(9):1016-21. doi: 10.1093/gerona/62.9.1016.
Inflammation plays a major role in both aging and chronic disease. Longitudinal studies in very old people can improve our understanding of these processes. We investigated blood levels of C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1 receptor antagonist (IL-1ra), and their combinations as predictors of mortality in nonagenarians.
This is a prospective population-based study including both community-dwelling and institutionalized nonagenarians enrolled in the Vitality 90+ Study. Altogether 285 persons participated in the baseline interview and gave blood. Information on chronic disease was drawn from health center registers. Data on mortality over 4 years were obtained from the Population Register Center. In Cox proportional hazards models, chronic disease and major risk factors were adjusted for.
Plasma levels of IL-1ra, IL-6, and CRP were higher in persons who died during the follow-up than in those who survived. When sex, education, cardiovascular disease, diabetes, cancer, history of infections, high density lipoprotein cholesterol, Mini-Mental State Examination, body mass index, smoking status, and exercise were adjusted for, only IL-1ra was a significant predictor of mortality (hazard ratio [HR] 2.12; 95% confidence interval [CI], 1.24-3.62). Persons in the upper tertiles of both CRP and IL-1ra (HR 2.72; 95% CI, 1.25-6.00), or in the upper tertile of all three markers (HR 2.34; 95% CI, 1.23-4.61), had higher mortality than those who were not in the upper tertile in any of the markers.
IL-1ra is a powerful prognostic marker in very old people. Our results implicate its role in the complex interaction between inflammatory markers in aging and disease.
炎症在衰老和慢性疾病中均起主要作用。针对极高龄人群的纵向研究有助于增进我们对这些过程的理解。我们研究了非agenarians中C反应蛋白（CRP）、白细胞介素-6（IL-6）、白细胞介素-1受体拮抗剂（IL-1ra）的血液水平及其组合作为死亡率预测指标的情况。
这是一项基于人群的前瞻性研究，纳入了参加“活力90 +研究”的社区居住和机构养老的非agenarians。共有285人参加了基线访谈并提供了血液样本。慢性病信息取自健康中心登记册。4年死亡率数据来自人口登记中心。在Cox比例风险模型中，对慢性病和主要危险因素进行了校正。
随访期间死亡者的血浆IL-1ra、IL-6和CRP水平高于存活者。在校正了性别、教育程度、心血管疾病、糖尿病、癌症、感染史、高密度脂蛋白胆固醇、简易精神状态检查、体重指数、吸烟状况和运动情况后，只有IL-1ra是死亡率的显著预测指标（风险比[HR] 2.12；95%置信区间[CI]，1.24 - 3.62）。CRP和IL-1ra处于上三分位数的人群（HR 2.72；95% CI，1.25 - 6.00），或所有三个标志物均处于上三分位数的人群（HR 2.34；95% CI，1.23 - 4.61），其死亡率高于任何一个标志物均未处于上三分位数的人群。
IL-1ra是极高龄人群中一个强有力的预后标志物。我们的结果表明其在衰老和疾病中炎症标志物之间的复杂相互作用中发挥作用。
