Mekli Krisztina, Marshall Alan, Nazroo James, Vanhoutte Bram, Pendleton Neil
Cathie Marsh Institute for Social Research, University of Manchester, Manchester M13 9PT, UK.
Cathie Marsh Institute for Social Research, University of Manchester, Manchester M13 9PT, UK present address: School of Geography and Geosciences, University of St Andrews, St Andrews, UK.
Age Ageing. 2015 Nov;44(6):938-42. doi: 10.1093/ageing/afv122. Epub 2015 Sep 22.
The term frailty refers to a condition of increased vulnerability to stressors among older people, leading to a decline in homeostatic reserve. Frailty often leads to falls, hospitalisation and mortality, hence its importance for the delivery of health care to older adults. The pathophysiological mechanisms behind frailty are not well understood, but the decreased steroid-hormone production and elevated chronic systemic inflammation of older people appear to be major contributors.
We used a sample of 3,160 individuals aged 50 or older from the English Longitudinal Study of Ageing and assessed their frailty status according to a Frailty Index. We selected 620 single nucleotide polymorphisms in genes involved in the steroid hormone or inflammatory pathways. We performed linear association analysis. The outcome variable was the square root transformation of the Frailty Index, with age and sex entered as covariates.
The strongest signal was detected in the pro-inflammatory Interleukin-18 gene (rs360722, P = 0.0021, β = -0.015). Further significant signals were observed in the Interleukin-12 (rs4679868, P = 0.0062, β = -0.008 and rs9852519, P = 0.0077, β = -0.008), low density lipoprotein receptor-related protein 1 (rs1799986, P = 0.0065, β = 0.011) and Selectin-P (rs6131, P = 0.0097, β = -0.01) genes. None of these associations remain significant after Bonferroni correction.
We show potential associations between genetic variants of four genes and the frailty index. These genes are involved in the cholesterol transport and inflammatory pathway and, as such, our results provide further support for the involvement of the immunological processes in frailty of the elderly.
衰弱这一术语指的是老年人对应激源的易感性增加的一种状态,会导致体内稳态储备下降。衰弱常常会导致跌倒、住院和死亡,因此它对于为老年人提供医疗保健至关重要。衰弱背后的病理生理机制尚未完全明确,但老年人类固醇激素分泌减少和慢性全身性炎症加剧似乎是主要原因。
我们从英国老龄化纵向研究中选取了3160名50岁及以上的个体作为样本,并根据衰弱指数评估他们的衰弱状态。我们在参与类固醇激素或炎症途径的基因中选择了620个单核苷酸多态性。我们进行了线性关联分析。结果变量是衰弱指数的平方根转换值,将年龄和性别作为协变量纳入。
在促炎白细胞介素-18基因(rs360722,P = 0.0021,β = -0.015)中检测到最强信号。在白细胞介素-12(rs4679868,P = 0.0062,β = -0.008和rs9852519,P = 0.0077,β = -0.008)、低密度脂蛋白受体相关蛋白1(rs1799986,P = 0.0065,β = 0.011)和选择素-P(rs6131,P = 0.0097,β = -0.01)基因中观察到进一步的显著信号。经Bonferroni校正后,这些关联均不再显著。
我们展示了四个基因的遗传变异与衰弱指数之间的潜在关联。这些基因参与胆固醇转运和炎症途径,因此,我们的结果为免疫过程参与老年人衰弱提供了进一步支持。