Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Center on Aging and Health, Johns Hopkins University and Medical Institutions, Baltimore, Maryland.
J Gerontol A Biol Sci Med Sci. 2019 Apr 23;74(5):720-725. doi: 10.1093/gerona/gly120.
Chronically elevated interleukin-6 (IL-6) levels contribute to fatigue and functional decline via multiple pathways that often lead to frailty. Lesser known is the contribution of IL-6 to fatigue in relation to a standardized workload (fatigability), a precursor to functional decline. Therefore, the purpose of this study was to examine the longitudinal relationship between IL-6 and fatigability.
About 985 participants from the Baltimore Longitudinal Study of Aging (mean age: 70 ± 10 years) were evaluated every 1-4 years. IL-6 was measured in fasting serum samples at each visit and log-transformed for analyses. Perceived fatigability (PF) was defined as self-reported exertion (rate of perceived exertion; RPE) after a 5-min, 0.67 m/s, 0% grade treadmill walk. Continuous and categorical associations between IL-6 (baseline and repeated measures) and PF were assessed using generalized estimating equations, adjusting for demographics, behavioral factors, and comorbid conditions.
In fully adjusted continuous models, twofold higher baseline IL-6 was associated with a 0.28 higher RPE (p = .03). This relationship tended to remain constant annually (baseline log IL-6 by time interaction p = .29). To provide clinical relevance, the sample median (3.7 pg/mL) was used to examine high versus low IL-6 levels. Over time, the high group reported an average 0.25 higher RPE (p = .03) than the low group. Annual change in logged IL-6 was not associated with annual change in PF (p = .48).
Findings suggest that elevated IL-6 is a biomarker of physiological dysregulation associated with greater fatigability, but there is no longitudinal association between IL-6 and fatigability. Future studies should evaluate whether interventions that aim to reduce inflammation also attenuate fatigability.
慢性升高的白细胞介素-6(IL-6)水平通过多种途径导致疲劳和功能下降,这些途径通常导致虚弱。鲜为人知的是,IL-6 对与标准化工作量(易疲劳性)相关的疲劳的贡献,这是功能下降的前兆。因此,本研究的目的是研究 IL-6 与易疲劳性之间的纵向关系。
巴尔的摩老龄化纵向研究(平均年龄:70±10 岁)中的约 985 名参与者每 1-4 年接受一次评估。在每次就诊时测量空腹血清样本中的 IL-6,并进行对数转换以进行分析。感知疲劳(PF)定义为 5 分钟、0.67m/s、0%坡度跑步机行走后的自我报告用力程度(感觉用力率;RPE)。使用广义估计方程评估 IL-6(基线和重复测量)与 PF 之间的连续和分类关联,调整了人口统计学、行为因素和合并症。
在完全调整的连续模型中,基线 IL-6 增加两倍与 RPE 增加 0.28 相关(p=0.03)。这种关系似乎每年都保持不变(基线 log IL-6 与时间的相互作用 p=0.29)。为了提供临床相关性,使用样本中位数(3.7pg/mL)来检查高与低 IL-6 水平。随着时间的推移,高组报告的 RPE 平均比低组高 0.25(p=0.03)。IL-6 的年变化与 PF 的年变化无关(p=0.48)。
研究结果表明,升高的 IL-6 是与易疲劳性相关的生理失调的生物标志物,但 IL-6 与易疲劳性之间没有纵向关联。未来的研究应评估旨在减少炎症的干预措施是否也能减轻易疲劳性。