Liu Wei, Fan Lieyang, Shi Da, Yu Linling, Song Jiahao, Liang Ruyi, Lai Xuefeng, Wang Hao, Zhang Yongfang, Wan Shuhui, Yang Yueru, Wang Bin
Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
Medical Big Data and Bioinformatics Research Centre, First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, 341000, China.
BMC Med. 2024 Dec 18;22(1):590. doi: 10.1186/s12916-024-03805-1.
The overall effect of long-term variability in physiological measures on cardiovascular health of older adults and the underlying mechanic pathway remain uncertain.
We constructed a composite score (0 ~ 3) of variability in physiological measures, including blood pressure, pulse rate, and body mass index, in older adults from the China Health and Retirement Longitudinal Study (CHARLS) 2011 ~ 2015, the Health and Retirement Study (HRS) 2006/2008 ~ 2014/2016, and the UK Biobank 2006 ~ 2019. The associations of the composite score with incident risks of heart disease and stroke were assessed. The mediation roles of several biomarkers were explored.
A higher composite score was related to increased incident risk of heart disease in older adults from the US and the UK and increased incident risk of stroke in all three cohorts. Upon pooling the results, each 1-point increment in the composite score was associated with a 19% (hazard ratio: 1.19; 95% confidence interval: 1.14, 1.30) and a 23% (1.23; 1.12, 1.35) increments in incident risks of heart disease and stroke, respectively. The composite score also exhibited an inverse relationship with grip strength while displaying positive associations with C-reactive protein, glycosylated hemoglobin Alc (HbAlc), and cystatin C. Reduced grip strength, elevated HbAlc, and elevated cystatin C significantly mediated the composite score-associated elevated risks of heart disease and stroke.
Long-term variability in physiological measures was associated with increased incident risks of heart disease and stroke, and the associations were partially mediated through deteriorated biomarkers of muscle strength, hyperglycemia, and kidney function.
生理指标的长期变异性对老年人心血管健康的总体影响及其潜在的机制途径仍不确定。
我们构建了一个生理指标变异性的综合评分（0至3分），该评分纳入了来自中国健康与养老追踪调查（CHARLS，2011年至2015年）、健康与退休研究（HRS，2006/2008年至2014/2016年）以及英国生物银行（2006年至2019年）的老年人的血压、脉搏率和体重指数等生理指标。评估了该综合评分与心脏病和中风发病风险的关联。探讨了几种生物标志物的中介作用。
较高的综合评分与美国和英国老年人心脏病发病风险增加以及所有三个队列中风发病风险增加有关。汇总结果后，综合评分每增加1分，心脏病和中风发病风险分别增加19%（风险比：1.19；95%置信区间：1.14，1.30）和23%（1.23；1.12，1.35）。综合评分还与握力呈负相关，同时与C反应蛋白、糖化血红蛋白Alc（HbAlc）和胱抑素C呈正相关。握力降低、HbAlc升高和胱抑素C升高显著介导了综合评分相关的心脏病和中风发病风险升高。
生理指标的长期变异性与心脏病和中风发病风险增加有关，且这些关联部分是通过肌肉力量、高血糖和肾功能恶化的生物标志物介导的。
