Veronese Nicola, Stubbs Brendon, Smith Lee, Maggi Stefania, Jackson Sarah E, Soysal Pinar, Demurtas Jacopo, Celotto Stefano, Koyanagi Ai
National Research Council, Neuroscience Institute, Aging Branch, Via Giustiniani, 2, 35128, Padua, Italy.
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK.
Drugs Aging. 2019 Apr;36(4):387-393. doi: 10.1007/s40266-019-00642-3.
Angiotensin-converting enzyme inhibitors (ACEI) may have several pleiotropic effects, but the literature regarding a possible relationship between ACEI use and frailty is limited. We investigated whether ACEI use is associated with lower risk of frailty in a cohort of North American individuals.
Data from the Osteoarthritis Initiative, a cohort study with 8 years of follow-up including community-dwelling adults with knee osteoarthritis or at high risk for this condition, were analyzed. ACEI use was defined through self-reported information and confirmed by a trained interviewer. Frailty was defined using the Study of Osteoporotic Fracture (SOF) index as the presence of at least two of the following criteria: (1) weight loss ≥ 5% between baseline and any subsequent follow-up visit; (2) inability to do five chair stands; and (3) low energy level according to the SOF definition. A multivariable Poisson regression analysis was used to assess the association between ACEI use at baseline and incident frailty. The data were reported as relative risks (RRs) with their 95% confidence intervals (CIs).
The final sample consisted of 4295 adults (mean age 61.2 years, females 58.1%). At baseline, 551 participants (12.8%) used ACEI. After adjusting for 15 potential confounders, the use of ACEI was associated with a lower risk of frailty (RR 0.72; 95% CI 0.53-0.99). The adjustment for the propensity score substantially confirmed these findings (RR 0.75; 95% CI 0.54-0.996).
ACEI use may be associated with a reduced risk of frailty in individuals with/at risk of knee osteoarthritis, suggesting a potential role for ACI in the prevention of frailty.
血管紧张素转换酶抑制剂（ACEI）可能具有多种多效性作用，但关于ACEI使用与虚弱之间可能关系的文献有限。我们调查了在北美人群队列中，使用ACEI是否与较低的虚弱风险相关。
对骨关节炎倡议组织的数据进行了分析，该队列研究有8年随访，纳入了患有膝关节骨关节炎或有此疾病高风险的社区居住成年人。ACEI的使用通过自我报告信息定义，并由经过培训的访谈者进行确认。虚弱的定义采用骨质疏松性骨折研究（SOF）指数，即存在以下至少两条标准：（1）基线与任何后续随访之间体重减轻≥5%；（2）无法完成五次从椅子上站起的动作；（3）根据SOF定义能量水平低。采用多变量泊松回归分析来评估基线时ACEI的使用与新发虚弱之间的关联。数据以相对风险（RRs）及其95%置信区间（CIs）的形式报告。
最终样本包括4295名成年人（平均年龄61.2岁，女性占58.1%）。基线时，551名参与者（12.8%）使用ACEI。在对15个潜在混杂因素进行调整后，ACEI的使用与较低的虚弱风险相关（RR 0.72；95% CI 0.53 - 0.99）。倾向得分调整进一步证实了这些结果（RR 0.75；95% CI 0.54 - 0.996）。
在患有膝关节骨关节炎或有此风险的个体中，使用ACEI可能与较低的虚弱风险相关，提示ACEI在预防虚弱方面可能具有潜在作用。
