Rossi A P, Budui S, Zoico E, Caliari C, Mazzali G, Fantin F, D'Urbano M, Paganelli R, Zamboni M
A.P. Rossi, MD, PhD, Cattedra di Geriatria, Università di Verona, Ospedale Maggiore, Piazzale Stefani 1, 37126 VERONA, Italy, Tel:+39-45-8122537;FAX:+39-45-8122043, E-mail:
J Frailty Aging. 2017;6(2):65-71. doi: 10.14283/jfa.2017.4.
Investigate the presence of a correlation between systemic inflammatory profile of community-dwelling individuals and the loss of muscular mass and performance in old age over a 4.5y follow-up, focusing on the role of anti-inflammatory cytokines in muscular changes in elderly.
Longitudinal clinical study.
Subjects were randomly selected from lists of 11 general practitioners in the city of Verona, Italy.
The study included 120 subjects, 92 women and 28 men aged 72.27±2.06 years and with BMI of 26.52±4.07 kg/m2 at baseline.
Six minutes walking test (6MWT), appendicular and leg fat free mass (FFM) as measured with Dual Energy X-ray absorptiometry, were obtained at baseline and after 4.5 years (4.5y) of mean follow-up. Height, weight, body mass index (BMI), and circulating levels of TNFα, IL-4, IL-10, and IL-13 were evaluated at baseline.
A significant reduction of appendicular FFM, leg FFM and 6MWT performance (all p<0.001) was observed after 4.5 y follow-up. In a stepwise regression model, considering appendicular FFM decline as dependent variable, lnIL-4, BMI, baseline appendicular FFM, lnTNFα and lnIL-13 were significant predictors of appendicular FFM decline explaining 30.8% of the variance. While building a stepwise multiple regression considering leg FFM as a dependent variable, lnIL-4, BMI and leg FFM were significant predictors of leg FFM decline and explained 27.4% of variance. When considering 6MWT decline as a dependent variable, baseline 6MWT, lnIL-13 and lnTNFα were significant predictors of 6MWT decline to explain 22.9% of variance.
Our study suggest that higher serum levels of anti-inflammatory markers, and in particular IL-4 and IL-13, may play a protective role on FFM and performance maintenance in elderly subjects.
在4.5年的随访期内，调查社区居住个体的全身炎症特征与老年肌肉量和功能丧失之间的相关性，重点关注抗炎细胞因子在老年人肌肉变化中的作用。
纵向临床研究。
研究对象从意大利维罗纳市11名全科医生的名单中随机选取。
该研究纳入了120名受试者，其中92名女性和28名男性，基线时年龄为72.27±2.06岁，体重指数为26.52±4.07kg/m²。
在基线时以及平均随访4.5年（4.5y）后，进行6分钟步行试验（6MWT），并采用双能X线吸收法测量上肢和腿部去脂体重（FFM）。在基线时评估身高、体重、体重指数（BMI）以及TNFα、IL-4、IL-10和IL-13的循环水平。
随访4.5年后，观察到上肢FFM、腿部FFM和6MWT表现均显著降低（所有p<0.001）。在逐步回归模型中，以上肢FFM下降为因变量，lnIL-4、BMI、基线上肢FFM, lnTNFα和lnIL-13是上肢FFM下降的显著预测因素，可解释30.8%的方差。在构建以上肢FFM为因变量的逐步多元回归模型时，lnIL-4、BMI和上肢FFM是上肢FFM下降的显著预测因素，可解释27.4%的方差。当以6MWT下降为因变量时，基线6MWT、lnIL-13和lnTNFα是6MWT下降的显著预测因素, 可解释22.9%的方差。
我们的研究表明，较高的血清抗炎标志物水平，尤其是IL-4和IL-13，可能对老年受试者的FFM和功能维持起到保护作用。
