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社区居住的老年人中,血清中新蝶呤水平升高与普遍虚弱的 IL-6 无关的关联。

IL-6-independent association of elevated serum neopterin levels with prevalent frailty in community-dwelling older adults.

机构信息

Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University School of Medicine, Johns Hopkins Asthma and Allergy Center, Baltimore, MD 21224, USA.

出版信息

Age Ageing. 2011 Jul;40(4):475-81. doi: 10.1093/ageing/afr047. Epub 2011 May 17.

Abstract

BACKGROUND

neopterin is a monocyte/macrophage-derived immune activation marker and its levels increase with age. Frailty is an important clinical syndrome of old age. Previous studies have shown significant association between elevated interleukin-6 (IL-6) levels and frailty. The objective of this study was to evaluate IL-6-independent association of serum neopterin levels with prevalent frailty.

METHODS

this is a cross-sectional study in community-dwelling older adults recruited from residential and retirement communities in Baltimore, MD, USA. Frailty was determined using validated screening criteria. Serum neopterin and IL-6 levels were measured using standard enzyme-linked immunosorbent assay. Pearson correlation and multivariate linear regression analysis was performed to assess the relationship between log(neopterin) and log(IL-6). Odds ratios (ORs) for frailty were calculated using log(neopterin) and log(IL-6) as continuous measures and across tertiles of neopterin and IL-6 levels, adjusting for age, race, sex, education and body mass index.

RESULTS

one hundred and thirty-three individuals with a mean age of 84 years (range 72-97) completed the study. Neopterin levels were significantly higher in frail older adults than those in non-frail controls [median: 8.94 versus 8.35 nM, respectively, P < 0.001 t-test on log(neopterin)]. Log(neopterin) was significantly associated with prevalent frailty, adjusting for log(IL-6). Participants in the top tertile of neopterin had OR of 3.80 [95% confidence interval (CI) = 1.36-10.6, P < 0.01] for frailty. As expected, participants in the top tertile of IL-6 had OR of 3.29 (95% CI = 1.21-7.86, P < 0.05) for frailty. Log(neopterin) correlated with log(IL-6) (correlation coefficient = 0.19, P < 0.05). Moreover, OR for participants in the top neopterin tertile remained significant after adjusting for IL-6 (OR = 3.97, 95% CI = 1.15-13.72, P < 0.05).

CONCLUSION

elevated neopterin levels had IL-6-independent association with prevalent frailty, suggesting potential monocyte/macrophage-mediated immune activation in the frail elderly.

摘要

背景

新蝶呤是一种由单核细胞/巨噬细胞产生的免疫激活标志物,其水平随年龄增长而升高。衰弱是老年的一种重要临床综合征。先前的研究表明,白细胞介素 6(IL-6)水平升高与衰弱显著相关。本研究旨在评估血清新蝶呤水平与普遍衰弱之间无 IL-6 相关的关联。

方法

这是一项在美国马里兰州巴尔的摩的住宅和退休社区中招募的社区居住的老年人的横断面研究。使用经过验证的筛选标准确定衰弱。使用标准酶联免疫吸附试验测量血清新蝶呤和 IL-6 水平。使用 Pearson 相关和多元线性回归分析评估 log(新蝶呤)与 log(IL-6)之间的关系。使用 log(新蝶呤)和 log(IL-6)作为连续指标,以及新蝶呤和 IL-6 水平的三分位值,计算衰弱的比值比(OR),调整年龄、种族、性别、教育程度和体重指数。

结果

133 名平均年龄为 84 岁(72-97 岁)的个体完成了研究。与非衰弱对照组相比,衰弱的老年人新蝶呤水平显着升高[中位数:8.94 与 8.35 nM,分别为,P <0.001 t 检验 log(新蝶呤)]。调整 log(IL-6)后,log(新蝶呤)与普遍衰弱显着相关。新蝶呤水平最高三分位的参与者衰弱的 OR 为 3.80 [95%置信区间(CI)=1.36-10.6,P <0.01]。如预期的那样,IL-6 水平最高三分位的参与者衰弱的 OR 为 3.29(95%CI=1.21-7.86,P <0.05)。log(新蝶呤)与 log(IL-6)相关(相关系数=0.19,P <0.05)。此外,调整 IL-6 后,新蝶呤最高三分位的参与者的 OR 仍然显着(OR=3.97,95%CI=1.15-13.72,P <0.05)。

结论

升高的新蝶呤水平与普遍衰弱具有独立于 IL-6 的关联,提示衰弱的老年人中存在潜在的单核细胞/巨噬细胞介导的免疫激活。

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