HIV 感染老年男性的纵向步态速度加速下降
Accelerated Longitudinal Gait Speed Decline in HIV-Infected Older Men.
作者信息
Schrack Jennifer A, Althoff Keri N, Jacobson Lisa P, Erlandson Kristine M, Jamieson Beth D, Koletar Susan L, Phair John, Ferrucci Luigi, Brown Todd T, Margolick Joseph B
机构信息
*Department of Epidemiology, Johns Hopkins Bloomberg, School of Public Health, Baltimore, Maryland; †Department of Medicine, University of Colorado School of Medicine, Denver Colorado; ‡Department of Medicine, Hemtaology/Oncology, David Geffen School of Medicine at UCLA, Los Angeles, California; §Division of Infectious Disease, Department of Internal Medicine, Ohio State University, Columbus, Ohio; ‖Translational Gerontology Branch, Intramural Research Program, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; ¶Division of Endocrineology and Metabolism, Internal Medicine, National Institute on Aging, National Institutes of Health, Baltimore, Maryland; and #Department of Molecular Microbiology and Immunology, Johns Hopkins School of Medicine, Baltimore, Maryland.
出版信息
J Acquir Immune Defic Syndr. 2015 Dec 1;70(4):370-6. doi: 10.1097/QAI.0000000000000731.
BACKGROUND
Gait speed predicts functional decline, disability, and death and is considered a biomarker of biological aging. Changes in gait speed in persons aging with HIV may provide an important method of gauging health and longevity in an under assessed population. The objective of this study was to evaluate and quantify the rate of gait speed decline in HIV-infected (HIV⁺) men compared with HIV-uninfected (HIV⁻) men.
METHODS
The study was nested in the Multicenter AIDS Cohort Study. The primary outcome was usual gait speed in meters per second measured between 2007 and 2013. Differences in the rate of gait speed decline and the incidence of clinically slow gait (<1.0 m/s) were assessed using multivariate linear regression models and Cox proportional hazards models, respectively.
RESULTS
A total of 2025 men (973 HIV⁺ and 1052 HIV⁻) aged 40 years and older contributed 21,187 person-visits (9955 HIV⁺ and 11,232 HIV⁻) to the analysis. Average gait speeds at the age 50 years were 1.24 and 1.19 m/s in HIV⁻ and HIV⁺ men, respectively (P < 0.001). In fully adjusted models, gait speed decline averaged 0.009 m/s per year after age 50 years (P < 0.001); this decline was 0.025 m/s per year greater in HIV⁺ men (P < 0.001). Moreover, HIV⁺ men had a 57% greater risk of developing clinically slow gait (adjusted hazard ratio = 1.57, 95% confidence interval: 1.27 to 1.91).
CONCLUSIONS
These findings indicate a faster rate of functional decline in HIV-infected men, suggesting greater risks of disability and death with advancing age.
背景
步速可预测功能衰退、残疾和死亡，被视为生物衰老的一个生物标志物。感染艾滋病毒的人群在衰老过程中步速的变化，可能为评估一个未得到充分评估的人群的健康状况和寿命提供一种重要方法。本研究的目的是评估并量化感染艾滋病毒（HIV⁺）的男性与未感染艾滋病毒（HIV⁻）的男性相比，其步速下降的速率。
方法
本研究嵌套于多中心艾滋病队列研究中。主要结局指标是2007年至2013年期间测量的以米每秒为单位的日常步速。分别使用多变量线性回归模型和Cox比例风险模型评估步速下降速率的差异以及临床步速缓慢（<1.0米/秒）的发生率。
结果
共有2025名年龄在40岁及以上的男性（973名HIV⁺和1052名HIV⁻）参与分析，贡献了21187人次（9955名HIV⁺和11232名HIV⁻）。50岁时，HIV⁻男性和HIV⁺男性的平均步速分别为1.24米/秒和1.19米/秒（P < 0.001）。在完全调整模型中，50岁后步速平均每年下降0.009米/秒（P < 0.001）；HIV⁺男性的下降速率每年快0.025米/秒（P < 0.001）。此外，HIV⁺男性出现临床步速缓慢的风险高57%（调整后风险比 = 1.57，95%置信区间：1.27至1.91）。
结论
这些发现表明感染艾滋病毒的男性功能衰退速率更快，提示随着年龄增长残疾和死亡风险更高。
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