老年慢性冠状动脉综合征患者血清白细胞介素-6、白蛋白和25-羟基维生素D水平与衰弱之间的关系。
A relationship among the blood serum levels of interleukin-6, albumin, and 25-hydroxyvitamin D and frailty in elderly patients with chronic coronary syndrome.
作者信息
Dai Jing-Rong, Li Jie, He Xu, Huang Hong, Li Yan
机构信息
School of Medicine Kunming University of Science and Technology Kunming China.
Department of Geriatrics The First People's Hospital of Yunnan Province Kunming China.
出版信息
Aging Med (Milton). 2022 Feb 27;5(1):17-29. doi: 10.1002/agm2.12201. eCollection 2022 Mar.
BACKGROUND
With the aggravation of the aging of the world population, frailty has become one of the common complications in elderly people. Its diagnosis is not objective, the pathogenesis is not clear, and interventions are not sound, thus intensifying the problem. Furthermore, frailty is closely associated with the occurrence and poor prognosis of coronary atherosclerotic heart disease. Moreover, few studies report on the prevalence of frailty in elderly patients with the chronic coronary syndrome (CCS).
OBJECTIVE
We aimed to investigate the prevalence of frailty in elderly patients with CCS. We analyzed the correlation between the blood serum levels of interleukin-6 (IL-6), albumin (Alb), and 25-hydroxyvitamin D (25(OH)D) with frailty in elderly patients with CCS. We have also provided recommendations for helping the objective diagnosis as well as proposed new intervention methods in the future.
METHODS
Two hundred eight-eight inpatients (≥60 years) with the chronic coronary syndrome were recruited at the Department of Geriatrics, the First People's Hospital of Yunnan Province, China. General information and laboratory examination data were collected. The comprehensive geriatric assessment was conducted via an internet-based platform of the Comprehensive Geriatric Assessment (inpatient version) developed by us, among which frailty was assessed by the Chinese version of Fried Frailty Phenotype, a component of the assessment scale.
RESULTS
Among the total number of old patients with CCS, 87 (30.2%) had no frailty, 93 (32.3%) had early frailty, and 108 (37.5%) had frailty. According to the multivariate logistic regression analysis, after adjusting for confounding factors, IL-6 (OR = 1.066, 95% CI 1.012-1.127), Alb (OR = 0.740, 95% CI 0.560-0.978), and 25(OH)D (OR = 0.798, 95% CI 0.670-0.949) were independently associated with frailty in the three groups of models.
CONCLUSION
IL-6 proved to be a risk factor for frailty in elderly patients with CCS, while Alb and 25(OH)D were protective factors, which make the potential targets for predicting and intervening frailty in elderly patients with CCS.
背景
随着全球人口老龄化的加剧，衰弱已成为老年人常见的并发症之一。其诊断缺乏客观性，发病机制尚不明确，干预措施也不完善，从而加剧了这一问题。此外，衰弱与冠状动脉粥样硬化性心脏病的发生及不良预后密切相关。而且，关于慢性冠状动脉综合征（CCS）老年患者衰弱患病率的研究报道较少。
目的
我们旨在调查 CCS 老年患者的衰弱患病率。分析 CCS 老年患者血清白细胞介素 -6（IL -6）、白蛋白（Alb）和 25 - 羟基维生素 D（25(OH)D）水平与衰弱之间的相关性。我们还为帮助客观诊断提供了建议，并提出了未来新的干预方法。
方法
在中国云南省第一人民医院老年医学科招募了 288 例年龄≥60 岁的慢性冠状动脉综合征住院患者。收集了一般信息和实验室检查数据。通过我们开发的基于互联网的综合老年评估（住院版）平台进行综合老年评估，其中衰弱通过评估量表的中文版 Fried 衰弱表型进行评估。
结果
在 CCS 老年患者总数中，87 例（30.2%）无衰弱，93 例（32.3%）有早期衰弱，108 例（37.5%）有衰弱。根据多因素逻辑回归分析，在调整混杂因素后，IL -6（OR = 1.066，95%CI 1.012 - 1.127）、Alb（OR = 0.740，95%CI 0.560 - 0.978）和 25(OH)D（OR = 0.798，95%CI 0.670 - 0.949）在三组模型中均与衰弱独立相关。
结论
IL -6 被证明是 CCS 老年患者衰弱的危险因素，而 Alb 和 25(OH)D 是保护因素，这使得它们成为预测和干预 CCS 老年患者衰弱的潜在靶点。
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