Duan Yuting, Li Zhe, Zhang Weiguang, Niu Yue, Wang Bin, Feng Zhe, Sun Ding, Li Hao, Zhang Zehao, Qu Zeyu, Wang Qiushi, Jin Xinye, Zhang Jie, Liu Miao, Hu Hongyan, Zhao Yali, He Yao, Cai Guangyan, Hu Song, Chen Xiangmei, Chen Yizhi
Department of Geriatric Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Nephrology, Hainan Hospital of Chinese PLA General Hospital, Academician Chen Xiangmei of Hainan Province Kidney Diseases Research Team Innovation Center, Sanya, 572013, China.
Immun Ageing. 2025 Jun 19;22(1):24. doi: 10.1186/s12979-025-00520-0.
The purpose of this study was to determine the relationship between the serum levels of kappa (κ) and lambda (λ) total light chain (TLC), the κ/λ ratio, and the combined serum TLCκ and TLCλ (ΣTLC) levels in Chinese centenarians and all-cause mortality. The association between serum TLC and all-cause mortality was investigated using restricted cubic spline (RCS) analysis, Cox proportional hazards models, and Kaplan‒Meier curves. The study included 906 centenarians (18.8% male), 838 (92.5%) of whom died during a median follow-up of 30 months. The proportions of centenarians with abnormal TLCκ and TLCλ levels were 68.1% and 49.0%, respectively. RCS analysis indicated that the levels of TLCκ, TLCλ, and ΣTLC were associated with all-cause mortality (P < 0.05), whereas the κ/λ ratio was not (P > 0.05). Cox proportional hazards analysis demonstrated that the highest quartiles of TLCκ, TLCλ, and ΣTLC were associated with an increased risk of death, with hazard ratios of 1.434 (95% confidence interval [CI], 1.061-1.939; P = 0.019), 1.351 (95% CI, 1.013-1.802; P = 0.041), and 1.891 (95% CI, 1.347-2.654; P < 0.001), respectively. Kaplan-Meier analysis illustrated that centenarians with higher levels of TLCκ, TLCλ, and ΣTLC had significantly shorter median survival times (26 months versus 35 months, P < 0.001; 26 months versus 32 months, P = 0.003; and 26 months versus 36 months, P < 0.001, respectively). Our findings suggest that serum levels of TLCκ, TLCλ, and ΣTLC are significantly associated with all-cause mortality in centenarians. Trial registration Not applicable.
本研究旨在确定中国百岁老人血清κ（κ）和λ（λ）总轻链（TLC）水平、κ/λ比值以及血清TLCκ与TLCλ联合水平（ΣTLC）与全因死亡率之间的关系。使用受限立方样条（RCS）分析、Cox比例风险模型和Kaplan-Meier曲线研究血清TLC与全因死亡率之间的关联。该研究纳入了906名百岁老人（男性占18.8%），其中838人（92.5%）在30个月的中位随访期内死亡。TLCκ和TLCλ水平异常的百岁老人比例分别为68.1%和49.0%。RCS分析表明，TLCκ、TLCλ和ΣTLC水平与全因死亡率相关（P<0.05），而κ/λ比值则无相关性（P>0.05）。Cox比例风险分析显示，TLCκ、TLCλ和ΣTLC的最高四分位数与死亡风险增加相关，风险比分别为1.434（95%置信区间[CI]，1.061 - 1.939；P = 0.019）、1.351（95%CI，1.013 - 1.802；P = 0.041）和1.891（95%CI，1.347 - 2.654；P<0.001）。Kaplan-Meier分析表明，TLCκ、TLCλ和ΣTLC水平较高的百岁老人中位生存时间显著缩短（分别为26个月对35个月，P<0.001；26个月对32个月，P = 0.003；26个月对36个月，P<0.001）。我们的研究结果表明，血清TLCκ、TLCλ和ΣTLC水平与百岁老人的全因死亡率显著相关。试验注册 不适用。
