Sousa Ana Carolina Patrício Albuquerque, Zunzunegui Maria-Victoria, Li Annie, Phillips Susan P, Guralnik Jack M, Guerra Ricardo Oliveira
CNPQ Programa de Pós Graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, Brazil.
Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), Montreal, Canada École de santé publique, Université de Montréal, Montréal, Canada.
Age Ageing. 2016 Mar;45(2):274-80. doi: 10.1093/ageing/afv202. Epub 2016 Jan 28.
C-reactive protein (CRP) is a widely used cardiovascular risk marker, but questions remain about its role in the disability process in old age. This study examines the associations between CRP levels and physical performance in old age in different societies.
data were collected during the baseline survey of IMIAS in 2012 in Kingston (Canada), Saint-Hyacinthe (Canada), Manizales (Colombia) and Natal (Brazil). Approximately 200 men and 200 women aged 65-74 were recruited at each site. CRP was assessed using a high sensitivity assay and categorised as low (<1 mg/l), moderate (1-3 mg/l), high (3-10 mg/l) and very high (≥10 mg/l). Participants were interviewed at home; blood pressure, weight and height were measured. Physical function was assessed with the Short Physical Performance Battery (SPPB) and hand grip strength. Data were analysed using descriptive statistics, bivariate analysis (χ²) and linear or logistic regression.
CRP was significantly associated with low hand grip strength and poor physical performance in bivariate analyses. Hand grip strength association with CRP disappeared after adjustment by socioeconomic factors and health behaviours. The odds of poor physical function was OR = 2.67 [95% CI 1.43-4.99] comparing the highest and lowest CRP categories after adjustment by relevant covariates. The three SPPB components were assessed separately. Graded associations between low CRP and faster gait speed and shorter time to rise from a chair were observed in adjusted models. Association between impaired balance and CRP was attenuated after adjustment by relevant covariates, OR = 1.15 [0.65-2.04].
CRP could be a possible pathway from inflammation to physical decline in older populations.
C反应蛋白（CRP）是一种广泛应用的心血管风险标志物，但关于其在老年残疾过程中的作用仍存在疑问。本研究探讨了不同社会中老年人CRP水平与身体机能之间的关联。
数据收集于2012年IMIAS在加拿大金斯顿、加拿大圣阿辛特、哥伦比亚马尼萨莱斯和巴西纳塔尔的基线调查。每个地点招募了约200名65 - 74岁的男性和200名女性。使用高灵敏度检测法评估CRP，并将其分为低（<1mg/L）、中（1 - 3mg/L）、高（3 - 10mg/L）和非常高（≥10mg/L）四类。参与者在家中接受访谈；测量血压、体重和身高。使用简短体能状况量表（SPPB）和握力评估身体功能。数据采用描述性统计、双变量分析（χ²）以及线性或逻辑回归进行分析。
在双变量分析中，CRP与低握力和身体机能差显著相关。经社会经济因素和健康行为调整后，握力与CRP的关联消失。在经相关协变量调整后，比较最高和最低CRP类别时，身体功能差的比值比为OR = 2.67 [95%置信区间1.43 - 4.99]。分别对SPPB的三个组成部分进行了评估。在调整模型中，观察到低CRP与更快的步速和从椅子上起身所需更短时间之间存在分级关联。经相关协变量调整后，平衡受损与CRP之间的关联减弱，OR = 1.15 [0.65 - 2.04]。
CRP可能是老年人群中从炎症到身体机能衰退的一条潜在途径。
