Office of Population Research, Princeton University, Princeton, New Jersey.
J Am Geriatr Soc. 2013 Oct;61(10):1743-9. doi: 10.1111/jgs.12446. Epub 2013 Sep 19.
To examine relationships between eight markers of inflammation (interleukin (IL)-6, IL-6 receptor (R), C-reactive protein (CRP), tumor necrosis factor (TNF)-alpha, TNF receptor 1 (R1), TNFR2, IL-1 receptor antagonist, IL-18) and incident loss of ability to walk 400 m.
Prospective cohort study.
Older adults enrolled in the Invecchiare in Chianti Study.
Community-dwelling participants aged 65 and older (N = 1,006).
The eight inflammatory markers were measured at baseline, and an inflammation score was calculated based on the number of inflammatory markers for which the participant was in the highest quartile. Incidence of mobility disability was determined in participants able to walk 400 m at baseline. Logistic regression models were used to determine whether each of the inflammatory markers and the inflammation score predicted loss of the ability to walk 400 m at 6-year follow-up.
After adjusting for covariates, individuals with a TNFR1 level in each of the highest three quartiles (Q2, 3, 4) were more likely to be unable to walk 400 m at follow-up than those with TNFR1 levels in Q1. When adjusting for the same covariates, participants with an inflammation score of 3 or 4 were more likely to become unable to walk 400 m at follow-up than participants with a score of 0.
These results provide additional evidence that inflammation is a factor in the mechanisms that cause incident mobility disability and suggest that a combined measure of inflammatory markers may improve prediction of functional prognosis.
探讨 8 种炎症标志物(白细胞介素(IL)-6、IL-6 受体(R)、C 反应蛋白(CRP)、肿瘤坏死因子(TNF)-α、TNF 受体 1(R1)、TNFR2、IL-1 受体拮抗剂、IL-18)与 400 米步行能力丧失事件之间的关系。
前瞻性队列研究。
参加“因维奇亚雷在奇安蒂研究”的老年人。
年龄在 65 岁及以上的社区居住参与者(N=1006)。
在基线时测量 8 种炎症标志物,并根据参与者处于最高四分位的炎症标志物数量计算炎症评分。在基线时能够行走 400 米的参与者中确定了移动障碍的发生率。使用逻辑回归模型确定每种炎症标志物和炎症评分是否预测了 6 年后丧失行走 400 米的能力。
在校正协变量后,TNFR1 水平处于最高三个四分位(Q2、3、4)的个体比 TNFR1 水平处于 Q1 的个体更有可能在随访时无法行走 400 米。当校正相同的协变量时,炎症评分 3 或 4 的参与者比炎症评分 0 的参与者更有可能在随访时无法行走 400 米。
这些结果提供了更多证据表明炎症是导致事件性移动障碍的机制中的一个因素,并表明炎症标志物的综合测量可能改善功能预后的预测。