Brinkley Tina E, Leng Xiaoyan, Miller Michael E, Kitzman Dalane W, Pahor Marco, Berry Michael J, Marsh Anthony P, Kritchevsky Stephen B, Nicklas Barbara J
Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
J Gerontol A Biol Sci Med Sci. 2009 Apr;64(4):455-61. doi: 10.1093/gerona/gln038. Epub 2009 Feb 4.
Chronic subclinical inflammation may contribute to impaired physical function in older adults; however, more data are needed to determine whether inflammation is a common mechanism for functional decline, independent of disease or health status.
We examined associations between physical function and inflammatory biomarkers in 542 older men and women enrolled in four clinical studies at Wake Forest University between 2001 and 2006. All participants were at least 55 years and had chronic obstructive pulmonary disease, congestive heart failure, high cardiovascular risk, or self-reported physical disability. Uniform clinical assessments were used across studies, including grip strength; a Short Physical Performance Battery (SPPB; includes balance, 4-m walk, and repeated chair stands); inflammatory biomarker assays for interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and C-reactive protein (CRP); and anthropometric measures.
Higher levels of CRP and IL-6, but not TNF-alpha, were associated with lower grip strength and SPPB scores and longer times to complete the 4-m walk and repeated chair stands tests, independent of age, gender, and race. More importantly, these relationships were generally independent of disease status. Further adjustment for fat mass, lean mass, or percent body fat altered some of these relationships but did not significantly change the overall results.
Elevated CRP and IL-6 levels are associated with poorer physical function in older adults with various comorbidities, as assessed by a common battery of clinical assessments. Chronic subclinical inflammation may be a marker of functional limitations in older persons across several diseases/health conditions.
慢性亚临床炎症可能导致老年人身体功能受损;然而,需要更多数据来确定炎症是否是功能衰退的常见机制,且独立于疾病或健康状况。
我们对2001年至2006年期间在维克森林大学参加四项临床研究的542名老年男性和女性的身体功能与炎症生物标志物之间的关联进行了研究。所有参与者年龄至少55岁,患有慢性阻塞性肺疾病、充血性心力衰竭、心血管疾病高风险或自我报告的身体残疾。各项研究采用统一的临床评估,包括握力;简短体能测试电池组(SPPB;包括平衡、4米步行和重复起坐);白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)和C反应蛋白(CRP)的炎症生物标志物检测;以及人体测量指标。
较高水平的CRP和IL-6,但不包括TNF-α,与较低的握力和SPPB分数以及完成4米步行和重复起坐测试所需的较长时间相关,且独立于年龄、性别和种族。更重要的是,这些关系通常独立于疾病状态。对脂肪量、瘦体重或体脂百分比进行进一步调整改变了其中一些关系,但并未显著改变总体结果。
通过一组常见的临床评估发现,CRP和IL-6水平升高与患有各种合并症的老年人较差的身体功能相关。慢性亚临床炎症可能是多种疾病/健康状况下老年人功能受限的一个标志。