Cheng Zongxue, He Di, Li Jun, Wu Qiong, Liu Zuyun, Zhu Yimin
Department of Epidemiology & Biostatistics, and Department of Respiratory Diseases of Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China.
Center for Clinical Big Data and Analytics, Second Affiliated Hospital and Department of Big Data in Health Science, School of Public Health, Zhejiang University School of Medicine, Hangzhou, 310058, Zhejiang, China.
Immun Ageing. 2022 Jun 3;19(1):29. doi: 10.1186/s12979-022-00280-1.
Systemic inflammation has been linked to diseases and frailty. However, little is known about the effect of systemic inflammation on frailty progression with a longitudinal study design.
This study aimed to investigate the associations of two inflammation indicators, C-reactive protein (CRP) and white blood cell (WBC), with frailty progression.
This study utilized data from the China Health and Retirement Longitudinal Study 2011-2018 (wave 1-wave 4). Frailty index (FI) was calculated using 40 items from wave 1 to wave 4 (range: 0 to 1). Two systemic inflammation biomarkers, CRP and WBC, were measured at baseline (wave 1) and logs transformed as continuous variables or grouped using quartiles. Linear mixed-effect models were used to analyze the associations of these two biomarkers with the progression of frailty with adjustment for potential confounding factors.
The study enrolled 9111 middle-aged and older participants (52.7% females, mean age 58.8 ± 9.3 years). The median follow-up time was 7.0 years. In a fully adjusted model with further adjustment for baseline FI, higher CRP (β for the interaction with time = 0.239, 95% CI: 0.139 to 0.338) and WBC (β for the interaction with time = 0.425, 95% CI: 0.024 to 0.825) significantly accelerated the rate of increase in the FI during the follow-up period. The associations were more pronounced in younger people (< 60 years) than older people (≥60 years).
Higher CRP and WBC accelerated the progression of frailty, particularly in younger groups (< 60 years). The findings suggest the importance of systemic inflammation for the early identification of people at high risk of rapid progression of frailty.
全身炎症与疾病和虚弱相关。然而，采用纵向研究设计对全身炎症对虚弱进展的影响了解甚少。
本研究旨在调查两种炎症指标，即C反应蛋白（CRP）和白细胞（WBC）与虚弱进展的关联。
本研究利用了中国健康与养老追踪调查2011 - 2018年（第1轮至第4轮）的数据。使用第1轮至第4轮的40项指标计算虚弱指数（FI）（范围：0至1）。在基线（第1轮）测量两种全身炎症生物标志物CRP和WBC，并将其对数转换为连续变量或按四分位数分组。使用线性混合效应模型分析这两种生物标志物与虚弱进展的关联，并对潜在混杂因素进行调整。
该研究纳入了9111名中老年参与者（52.7%为女性，平均年龄58.8±9.3岁）。中位随访时间为7.0年。在进一步调整基线FI的完全调整模型中，较高的CRP（与时间交互作用的β = 0.239，95%CI：0.139至0.338）和WBC（与时间交互作用的β = 0.425，95%CI：0.024至0.825）在随访期间显著加速了FI的增加速度。这种关联在年轻人（<60岁）中比老年人（≥60岁）中更为明显。
较高的CRP和WBC加速了虚弱的进展，特别是在较年轻的群体（<60岁）中。研究结果表明全身炎症对于早期识别有快速进展为虚弱高风险人群的重要性。
