Laudisio Alice, Bandinelli Stefania, Gemma Antonella, Ferrucci Luigi, Incalzi Raffaele Antonelli
Department of Geriatrics, Campus Bio-Medico University, Rome, Italy.
Geriatric Rehabilitation Unit, Azienda Sanitaria di Firenze, Florence, Italy.
J Gerontol A Biol Sci Med Sci. 2015 Jul;70(7):899-904. doi: 10.1093/gerona/glu211. Epub 2014 Nov 26.
Faster resting heart rate (HR), which is associated with inflammation and elevated cortisol levels, is a risk factor for excess cardiovascular morbidity and mortality. Obesity is associated with increased cardiovascular morbidity and mortality, inflammation, and elevated cortisol levels. The aim of the present study was to evaluate the interaction of Body Mass Index (BMI) with inflammation and cortisol in modulating HR in older subjects.
We analyzed data of 895 participants aged 65+ enrolled in the "InCHIANTI" study, in sinus rhythm, and not taking beta blockers or digoxin. Linear regression was performed to assess the adjusted association between HR, IL-6, and cortisol levels. The model was also analyzed stratifying for BMI tertiles. Logistic regression was adopted for evaluating the association of HR exceeding the mean value with Il-6 and serum cortisol.
According to multivariable linear regression, IL-6 and cortisol levels were associated with HR (B = 1.42, 95% CI = 0.43-2.42; p = .005 and B = .34, 95% CI = 0.17-.51; p < .0001, respectively). The association was significant only among women in the highest BMI tertile (B = 4.16, 95% CI = 1.40-6.91; p = .003 for IL-6 and B = .57, 95% CI = 0.14-1.01; p = .010 for cortisol). Logistic regression confirmed that IL-6 and cortisol levels were associated with HR above the mean value in the highest BMI tertile (OR = 2.13, 95% CI = 1.15-3.97; p = .009 and OR = 1.14, 95% CI = 1.03-1.25; p = .009, respectively).
Faster HR is associated with proinflammatory state in elderly patients; this association seems to be limited to women with higher BMI.
静息心率加快与炎症及皮质醇水平升高有关，是心血管疾病发病率和死亡率过高的一个危险因素。肥胖与心血管疾病发病率和死亡率增加、炎症及皮质醇水平升高有关。本研究的目的是评估体重指数（BMI）与炎症和皮质醇在调节老年受试者心率方面的相互作用。
我们分析了参加“基安蒂研究（InCHIANTI）”的895名65岁及以上参与者的数据，这些参与者为窦性心律，且未服用β受体阻滞剂或地高辛。进行线性回归以评估心率、白细胞介素-6（IL-6）和皮质醇水平之间的校正关联。该模型还按BMI三分位数进行分层分析。采用逻辑回归评估心率超过平均值与IL-6和血清皮质醇之间的关联。
根据多变量线性回归，IL-6和皮质醇水平与心率相关（B = 1.42，95%置信区间 = 0.43 - 2.42；p = 0.005；B = 0.34，95%置信区间 = 0.17 - 0.51；p < 0.0001）。这种关联仅在BMI最高三分位数的女性中显著（IL-6：B = 4.16，95%置信区间 = 1.40 - 6.91；p = 0.003；皮质醇：B = 0.57，95%置信区间 = 0.14 - 1.01；p = 0.010）。逻辑回归证实，在BMI最高三分位数中，IL-6和皮质醇水平与高于平均值的心率相关（OR = 2.13，95%置信区间 = 1.15 - 3.97；p = 0.009；OR = 1.14，95%置信区间 = 1.03 - 1.25；p = 0.009）。
老年患者心率加快与促炎状态有关；这种关联似乎仅限于BMI较高的女性。
