Department of Public Health, Yamagata University Graduate School of Medical Science, Yamagata, Japan.
J Gerontol A Biol Sci Med Sci. 2012 May;67(5):530-6. doi: 10.1093/gerona/glr191. Epub 2011 Oct 19.
Mortality risk tends to be higher among elderly individuals with higher serum adiponectin levels. The objective of this study was to clarify whether the relationship between adiponectin and a higher risk of disability or death can be explained by physical function, bone mineral density, depression, and malnutrition.
We analyzed 505 individuals who underwent comprehensive geriatric assessment and who agreed to provide information on long-term care insurance. The endpoint was the composite outcome of death and incident disability defined as a first certification for any level of care need. Relationships between adiponectin and incident disability or death were estimated using the Cox proportional hazards model.
During 6 years of follow-up, 179 incident disabilities or deaths occurred. Among them, 20 and 23 died with and without disability, respectively. The risk of incident disability or death was significantly higher among participants with adiponectin greater than or equal to 22.4 (90%) than 8.0 or less (25%) mg/L (Hazard ratio: 95% confidence interval, 1.92: 1.01-3.64) in the model adjusted for age, sex, and metabolic risk factors. Adjustment for N-terminal pro-B-type natriuretic peptide and nutritional status did not substantially alter this risk estimate, although the association ceased to be statistically significant. Adjustment for physical function did attenuate the relationship, however, which ceased to be apparent upon exclusion of disability or death occurring within 3 years of follow-up.
The relationship between adiponectin and the composite outcome of incident disability and death was at least partly explained by reduced physical function and wasting in participants with higher adiponectin levels.
血清脂联素水平较高的老年人死亡率往往较高。本研究旨在阐明脂联素与残疾或死亡风险增加之间的关系是否可以通过身体机能、骨密度、抑郁和营养不良来解释。
我们分析了 505 名接受全面老年评估并同意提供长期护理保险信息的个体。终点是残疾和死亡的复合结局，定义为任何护理需求水平的首次认证。使用 Cox 比例风险模型估计脂联素与残疾或死亡的发生之间的关系。
在 6 年的随访期间，发生了 179 例残疾或死亡事件。其中，20 例死亡且伴有残疾，23 例死亡但无残疾。脂联素大于或等于 22.4（90%）mg/L 的参与者发生残疾或死亡的风险明显高于脂联素 8.0 或以下（25%）mg/L 的参与者（风险比：95%置信区间，1.92:1.01-3.64），该模型调整了年龄、性别和代谢危险因素。调整 N 末端 B 型利钠肽前体和营养状况并未显著改变这一风险估计值，尽管关联不再具有统计学意义。调整身体机能会减弱这种关系，但在排除随访 3 年内发生的残疾或死亡后，这种关系就不再明显。
在脂联素水平较高的参与者中，脂联素与残疾和死亡复合结局之间的关系至少部分是由身体机能下降和消瘦引起的。
