10 年 C 反应蛋白轨迹与健康老龄化标志物的关联：来自英国老龄化纵向研究的结果。
Association of 10-Year C-Reactive Protein Trajectories With Markers of Healthy Aging: Findings From the English Longitudinal Study of Aging.
机构信息
Department of Epidemiology and Public Health, London, UK.
Department of Behavioural Science and Health, University College London, London, UK.
出版信息
J Gerontol A Biol Sci Med Sci. 2019 Jan 16;74(2):195-203. doi: 10.1093/gerona/gly028.
BACKGROUND
Elevated systematic inflammation is a hallmark of aging, but the association of long-term inflammation trajectories with subsequent aging phenotypes has been little examined. We assessed inflammatory marker C-reactive protein (CRP) repeatedly over time and examined whether long-term changes predicted aging outcomes.
METHODS
A total of 2,437 men and women aged 47-87 years at baseline (1998-2001) who were participants in the English Longitudinal Study of Ageing had CRP measured on two or three occasions between 1998 and 2009. Inflammation trajectories were computed using latent-class growth mixture modeling and were related to aging outcomes measured in 2012/2013: physical functioning, cardiometabolic, respiratory, mental health, and a composite "healthy aging" outcome.
RESULTS
Four CRP trajectories were identified as follows: "stable-low" (71 per cent of the sample) with baseline mean 1.33 mg/L remaining <3 mg/L; "medium-to-high" (14 per cent) with baseline 2.7 mg/L rising to 5.3 mg/L; "high-to-medium" (10 per cent) with baseline 6.6 mg/L decreasing to 2.4 mg/L; and "stable-high" (5 per cent) with levels from 5.7 to 7.5 mg/L. Relative to the stable-low trajectory, individuals in the medium-to-high had a higher risk of limitations in basic activities of daily living (ADL, odds ratio; 95% confidence interval: 2.09; 1.51, 2.88), instrumental ADL (1.62; 1.15, 2.30), impaired balance (1.59; 1.20, 2.11) and walking speed (1.61; 1.15, 2.24), arthritis (1.55; 1.16, 2.06), hypertension (1.57; 1.21, 2.04), obesity (1.95; 1.36, 2.80), poor respiratory function (1.84; 1.36, 2.50), and depression (1.55; 1.13, 2.12). A lower odds of healthy aging was observed in people in the medium-to-high (0.57; 0.40, 0.79) and stable-high (0.50; 0.27, 0.91) trajectories.
CONCLUSIONS
Older people who displayed an elevation in CRP levels over a decade experienced an increased risk of adverse aging outcomes.
背景
系统炎症水平升高是衰老的一个标志，但长期炎症轨迹与随后的衰老表型之间的关系尚未得到充分研究。我们在一段时间内多次评估炎症标志物 C 反应蛋白 (CRP)，并研究其长期变化是否可以预测衰老结果。
方法
共有 2437 名年龄在 47-87 岁之间的男性和女性在基线时（1998-2001 年）参加了英国老龄化纵向研究，他们在 1998 年至 2009 年期间有两次或三次 CRP 检测。使用潜在类别增长混合模型计算炎症轨迹，并将其与 2012/2013 年测量的衰老结果相关联：身体功能、心血管代谢、呼吸、心理健康和综合“健康衰老”结果。
结果
确定了四种 CRP 轨迹，如下所示：“稳定低”（样本的 71%），基线平均水平 1.33mg/L，保持<3mg/L；“中高”（14%），基线 2.7mg/L 上升至 5.3mg/L；“高至中”（10%），基线 6.6mg/L 下降至 2.4mg/L；和“稳定高”（5%），水平为 5.7-7.5mg/L。与稳定低的轨迹相比，中高轨迹的个体在基本日常生活活动（ADL）受限方面的风险更高（优势比；95%置信区间：2.09；1.51，2.88）、工具性 ADL（1.62；1.15，2.30）、平衡受损（1.59；1.20，2.11）和行走速度（1.61；1.15，2.24）、关节炎（1.55；1.16，2.06）、高血压（1.57；1.21，2.04）、肥胖（1.95；1.36，2.80）、呼吸功能差（1.84；1.36，2.50）和抑郁（1.55；1.13，2.12）。在中高（0.57；0.40，0.79）和稳定高（0.50；0.27，0.91）轨迹中，健康老龄化的可能性较低。
结论
在十年期间 CRP 水平升高的老年人出现不良衰老结果的风险增加。
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