Fan Dong, Chen Xia, Fa Wenxin, Liang Xiaoyan, Han Xiaolei, Wang Yongxiang, Cong Lin, Liang Yajun, Welmer Anna-Karin, Hou Tingting, Du Yifeng, Qiu Chengxuan
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China; International Medical Services, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China; Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, PR China; Shandong Provincial Clinical Research Centre for Neurological Diseases, Jinan, Shandong, PR China; Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, Shandong, PR China.
Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, PR China; Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, PR China; Shandong Provincial Clinical Research Centre for Neurological Diseases, Jinan, Shandong, PR China; Medical Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Science, Jinan, Shandong, PR China.
Arch Gerontol Geriatr. 2023 Jun;109:104963. doi: 10.1016/j.archger.2023.104963. Epub 2023 Feb 14.
We examined the association of modifiable cardiovascular health (CVH) metrics with physical function among rural older adults in China and the potential role of inflammatory mechanisms in the association. This study included 3733 stroke- and dementia-free participants (age ≥65 years; 56.9% women) in the baseline survey of a multimodal intervention study in rural China. From March-September 2018, data were collected via face-to-face interviews, clinical assessments, and laboratory tests. The Short Performance Physical Battery (SPPB) test was performed to assess physical function. We defined six modifiable CVH metrics according to the modified American Heart Association's recommendations. Serum interleukin (IL)-6 was measured in a subsample (n = 1156). Data were analyzed with multiple general linear and logistic regression models and structural equation modeling. Poor physical function (SPPB score ≤9) was defined in 1443 participants. Ideal CVH (vs. poor CVH) was associated with multivariable-adjusted odds ratio of 0.60 (95%CI 0.48-0.75) for poor physical function. Ideal CVH was significantly associated with higher scores on balance, chair stand, and walking speed tests (all p < 0.05). Moreover, ideal CVH profile was associated with lower serum IL-6 (multivariable-adjusted β=-0.04; 95% CI -0.06, -0.01). Mediation analysis revealed that serum IL-6 accounted for 14% of the association of CVH with total SPPB score and 10% of the association with walking speed score (p < 0.05). This study suggests that an ideal CVH profile is associated with better physical function among stroke- and dementia-free older adults, partly via inflammatory mechanisms. The preventive implications of these findings warrant further investigation in cohort studies.
我们研究了中国农村老年人中可改变的心血管健康（CVH）指标与身体功能之间的关联，以及炎症机制在该关联中的潜在作用。本研究纳入了中国农村一项多模式干预研究基线调查中的3733名无中风和痴呆的参与者（年龄≥65岁；女性占56.9%）。2018年3月至9月期间，通过面对面访谈、临床评估和实验室检测收集数据。进行简短体能状况量表（SPPB）测试以评估身体功能。我们根据美国心脏协会修改后的建议定义了六个可改变的CVH指标。在一个子样本（n = 1156）中测量了血清白细胞介素（IL）-6。使用多重一般线性和逻辑回归模型以及结构方程模型对数据进行分析。1443名参与者被定义为身体功能较差（SPPB评分≤9）。理想的CVH（与较差的CVH相比）与身体功能较差的多变量调整优势比为0.60（95%CI 0.48 - 0.75）。理想的CVH与平衡、从椅子上站起和步行速度测试的较高得分显著相关（所有p < 0.05）。此外，理想的CVH状况与较低的血清IL-6相关（多变量调整β = -0.04；95%CI -0.06，-0.01）。中介分析显示，血清IL-6占CVH与总SPPB评分关联的14%，以及与步行速度评分关联的10%（p < 0.05）。本研究表明，理想的CVH状况与无中风和痴呆的老年人更好的身体功能相关，部分是通过炎症机制。这些发现的预防意义值得在队列研究中进一步探讨。
