独立超高龄老人的免疫特征和身体成分：长寿计划。
Immune Profile and Body Composition of Independent Oldest Old: The Longevous Project.
机构信息
Geriatrics and Gerontology, Escola Paulista de Medicina, Universidade Federal de SP, São Paulo, Brazil.
Infectology Lab, Research Escola Paulista de Medicina, Universidade Federal de SP, São Paulo, Brazil.
出版信息
Gerontology. 2023;69(6):660-670. doi: 10.1159/000527485. Epub 2023 Jan 19.
INTRODUCTION
Immunosenescence is associated with changes in lymphocyte function, thymus atrophy, and a chronic inflammatory process referred to as "inflammaging," which may in part be linked to eating disorders.
OBJECTIVE
The aim of the study was to determine the prevalence rate of immunological alterations, including immune risk profile (IRP), and their association with body composition in the oldest old individuals.
METHODS
A cross-sectional study of 201 older adults aged 80 years and over, able to walk unaided, with no cognitive or immunological impairment, and with no serious diseases was conducted. Blood samples were collected between 2012 and 2014 during the morning period, and the following tests were conducted: urea, creatinine, hemogram, fasting glucose, glycated hemoglobin, transferrin, albumin, 25-OH vitamin D, and high-sensitivity CRP. Plasma cytokines were measured and mononuclear cell counts were performed by flow cytometry. Anthropometric measurements and densitometry using dual-energy X-ray absorptiometry (DXA) were performed to assess body composition.
RESULTS
Mean age was 84.4 ± 3.7 years, and the numbers of T cells were CD4, 784.0 cell/µL; CD8, 371.0 cell/µL; and CD4/CD8, 2.4. The rate of CD4/CD8 <1 (IRP) was 9.4%, CD4/CD8 1-5 was 85.6%, while CD4/CD8 >5 was only 5.5%. CRP, tumor necrosis factor, IL1, IL4, IL6, and IL10 variables showed a high coefficient of variation but low mean values of 1.1 ± 3.1 mg/L for CRP (reference range <3 mg/L) and 3.9 ± 5.0 pg/mL for IL6 (reference range <7.0 pg/mL). The same pattern was found for all other inflammatory variables assessed, characterizing a population whose values indicated low level of inflammation, considering age. Lean mass, as measured by DXA, was higher in men than in women, while the inverse was found for fat % (p < 0.001). A positive association between CRP values and DXA fat % (p value: 0.007, r: 0.49) and a negative association between CRP values and DXA lean mass (p value: 0.046, r:-0.37) was observed.
CONCLUSION
In the independent oldest old, IRP rate proved low and high-sensitivity CRP was shown to be associated with body composition.
简介
免疫衰老与淋巴细胞功能改变、胸腺萎缩以及被称为“炎症衰老”的慢性炎症过程有关，这可能部分与饮食失调有关。
目的
本研究旨在确定免疫改变的患病率，包括免疫风险谱（IRP），并确定其与最年长个体的身体成分的关系。
方法
对 201 名 80 岁及以上、能够独立行走、无认知或免疫功能障碍、无严重疾病的老年人进行了一项横断面研究。血液样本于 2012 年至 2014 年期间在上午采集，并进行了以下测试：尿素、肌酐、血常规、空腹血糖、糖化血红蛋白、转铁蛋白、白蛋白、25-羟维生素 D 和高敏 C 反应蛋白。通过流式细胞术测量血浆细胞因子并进行单核细胞计数。使用双能 X 射线吸收法（DXA）进行人体测量和密度测量，以评估身体成分。
结果
平均年龄为 84.4 ± 3.7 岁，T 细胞数为 CD4，784.0 个/μL；CD8，371.0 个/μL；CD4/CD8，2.4。CD4/CD8<1（IRP）的发生率为 9.4%，CD4/CD8 为 1-5 的发生率为 85.6%，而 CD4/CD8>5 的发生率仅为 5.5%。CRP、肿瘤坏死因子、IL1、IL4、IL6 和 IL10 变量的变异系数较高，但平均水平较低，CRP 为 1.1 ± 3.1mg/L（参考范围<3mg/L），IL6 为 3.9 ± 5.0pg/mL（参考范围<7.0pg/mL）。评估的所有其他炎症变量也呈现出相同的模式，这表明该人群的炎症水平较低，考虑到年龄因素。DXA 测量的瘦体重在男性中高于女性，而脂肪%则相反（p<0.001）。CRP 值与 DXA 脂肪%呈正相关（p 值：0.007，r：0.49），CRP 值与 DXA 瘦体重呈负相关（p 值：0.046，r：-0.37）。
结论
在独立的最年长人群中，IRP 发生率较低，高敏 C 反应蛋白与身体成分有关。
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