Inflammatory markers and incident frailty in men and women: the English Longitudinal Study of Ageing
Tóm tắt
Cross-sectional studies show that higher blood concentrations of inflammatory markers tend to be more common in frail older people, but longitudinal evidence that these inflammatory markers are risk factors for frailty is sparse and inconsistent. We investigated the prospective relation between baseline concentrations of the inflammatory markers C-reactive protein (CRP) and fibrinogen and risk of incident frailty in 2,146 men and women aged 60 to over 90 years from the English Longitudinal Study of Ageing. The relationship between CRP and fibrinogen and risk of incident frailty differed significantly by sex (p for interaction terms <0.05). In age-adjusted logistic regression analyses, for a standard deviation (SD) increase in CRP or fibrinogen, odds ratios (95 % confidence intervals) for incident frailty in women were 1.69 (1.32, 2.17) and 1.39 (1.12, 1.72), respectively. Further adjustment for other potential confounding factors attenuated both these estimates. For an SD increase in CRP and fibrinogen, the fully-adjusted odds ratio (95 % confidence interval) for incident frailty in women was 1.27 (0.96, 1.69) and 1.31 (1.04, 1.67), respectively. Having a high concentration of both inflammatory markers was more strongly predictive of incident frailty than having a high concentration of either marker alone. In men, there were no significant associations between any of the inflammatory markers and risk of incident frailty. High concentrations of the inflammatory markers CRP and fibrinogen are more strongly predictive of incident frailty in women than in men. Further research is needed to understand the mechanisms underlying this sex difference.
Tài liệu tham khảo
Bandeen-Roche K, Xue QL, Ferrucci L, Walston J, Guralnik JM, Chaves P, Zeger SL, Fried LP (2006) Phenotype of frailty: characterization in the women's health and aging studies. J Gerontol A Biol Sci Med Sci 61:262–266
Banks J, Karlsen S, Oldfield Z (2003) Socio-economic position. In: Marmot M, Banks J, Blundell R, Lessof C, Nazroo J (eds) Health, wealth and lifestyles of the older population in England. Institute of Fiscal Studies, London, pp 71–125
Barzilay JI, Blaum C, Moore T, Xue QL, Hirsch CH, Walston JD, Fried LP (2007) Insulin resistance and inflammation as precursors of frailty: the Cardiovascular Health Study. Arch Intern Med 167:635–641
Baylis D, Bartlett DB, Syddall HE, Ntani G, Gale CR, Cooper C, Lord JM, Sayer AA (2012) Immune-endocrine biomarkers as predictors of frailty and mortality: a 10-year longitudinal study in community-dwelling older people. Age (Dordr) [Epub ahead of print]
Bergman H, Ferrucci L, Guralnik J, Hogan DB, Hummel S, Karunananthan S, Wolfson C (2007) Frailty: an emerging research and clinical paradigm—issues and controversies. J Gerontol A Biol Sci Med Sci 62:731–737
Bowles LK, Cooper JA, Howarth DJ, Miller GJ, MacCallum PK (2003) Associations of haemostatic variables with body mass index: a community-based study. Blood Coagul Fibrinolysis 14:569–573
Collerton J, Martin-Ruiz C, Davies K, Hilkens CM, Isaacs J, Kolenda C, Parker C, Dunn M, Catt M, Jagger C, Von ZT, Kirkwood TB (2012) Frailty and the role of inflammation, immunosenescence and cellular ageing in the very old: cross-sectional findings from the Newcastle 85+ Study. Mech Ageing Dev 133:456–466
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156
Fried LP, Walston J (1998) Frailty and failure to thrive. In: Hazzard WR, Blass J, Ettinger WH, Halter J, Ouslander J (eds) Principles of geriatric medicine and gerontology. McGraw-Hill, New York, pp 1387–1402
Graig R, Deverill C, Pickering K (2006) Quality control of blood, saliva and urine analytes. In: Spronston K, Mindell J (eds) Health Survey for England 2004, methodology and documentation, vol 2. The Information Centre, London, pp 34–41
Hubbard RE, O'Mahony MS, Savva GM, Calver BL, Woodhouse KW (2009) Inflammation and frailty measures in older people. J Cell Mol Med 13:3103–3109
Jenny NS, Yanez ND, Psaty BM, Kuller LH, Hirsch CH, Tracy RP (2007) Inflammation biomarkers and near-term death in older men. Am J Epidemiol 165:684–695
Khera A, Vega GL, Das SR, Ayers C, McGuire DK, Grundy SM, de Lemos JA (2009) Sex differences in the relationship between C-reactive protein and body fat. J Clin Endocrinol Metab 94:3251–3258
Klenk J, Denkinger M, Nikolaus T, Peter R, Rothenbacher D, Koenig W (2013) Association of objectively measured physical activity with established and novel cardiovascular biomarkers in elderly subjects: every step counts. J Epidemiol Community Health 67:194–197
Lee CC, Adler AI, Sandhu MS, Sharp SJ, Forouhi NG, Erqou S, Luben R, Bingham S, Khaw KT, Wareham NJ (2009) Association of C-reactive protein with type 2 diabetes: prospective analysis and meta-analysis. Diabetologia 52:1040–1047
Leng SX, Xue QL, Tian J, Walston JD, Fried LP (2007) Inflammation and frailty in older women. J Am Geriatr Soc 55:864–871
Marmot M, Nazroo J, Banks J, Blundell R, Erens B, Lessof C, Huppert FA (2011) English Longitudinal Study of Ageing: Wave 0 (1998, 1999 and 2001) and Waves 1–4 (2002–2009) [computer file], 15th edn. UK Data Archive [distributor], Colchester, Essex, SN: 5050
Martin HJ, Syddall HE, Dennison EM, Cooper C, Sayer AA (2008) Relationship between customary physical activity, muscle strength and physical performance in older men and women: findings from the Hertfordshire Cohort Study. Age Ageing 37:589–593
Pruijm M, Vollenweider P, Mooser V, Paccaud F, Preisig M, Waeber G, Marques-Vidal P, Burnier M, Bochud M. (2013) Inflammatory markers and blood pressure: sex differences and the effect of fat mass in the CoLaus Study. J Hum Hypertens 27:169–175
Puts MT, Visser M, Twisk JW, Deeg DJ, Lips P (2005) Endocrine and inflammatory markers as predictors of frailty. Clin Endocrinol (Oxf) 63:403–411
Reiner AP, Aragaki AK, Gray SL, Wactawski-Wende J, Cauley JA, Cochrane BB, Kooperberg CL, Woods NF, LaCroix AZ (2009) Inflammation and thrombosis biomarkers and incident frailty in postmenopausal women. Am J Med 122:947–954
Rockwood K, Fox RA, Stolee P, Robertson D, Beattie BL (1994) Frailty in elderly people: an evolving concept. CMAJ 150:489–495
Rothenbacher D, Hoffmeister A, Brenner H, Koenig W (2003) Physical activity, coronary heart disease, and inflammatory response. Arch Intern Med 163:1200–1205
Rudnicka AR, Rumley A, Whincup PH, Lowe GD, Strachan DP (2011) Sex differences in the relationship between inflammatory and hemostatic biomarkers and metabolic syndrome: British 1958 Birth Cohort. J Thromb Haemost 9:2337–2344
Schmaltz HN, Fried LP, Xue QL, Walston J, Leng SX, Semba RD (2005) Chronic cytomegalovirus infection and inflammation are associated with prevalent frailty in community-dwelling older women. J Am Geriatr Soc 53:747–754
Steffick DE, The HRS working group (2000) Documentation of affective functioning measures in the Health and Retirement Study. HRS/AHEAD Documentation Report DR-005 [online report]
Steptoe A, Breeze E, Banks J, Nazroo J. (2012) Cohort Profile: The English Longitudinal Study of Ageing. Int J Epidemiol [Epub ahead of print]
Syddall H, Roberts HC, Evandrou M, Cooper C, Bergman H, Aihie SA (2010) Prevalence and correlates of frailty among community-dwelling older men and women: findings from the Hertfordshire Cohort Study. Age Ageing 39:197–203
Taylor R, Conway L, Calderwood L, Lessof C (2003) Methodology. In: Marmot M, Banks J, Blundell R, Lessof C, Nazroo J (eds) Health, wealth and lifestyles of the older population in England: the 2002 English Longitudinal Study of Ageing. Institute of Fiscal Studies, London, pp 357–374
Thorand B, Baumert J, Doring A, Herder C, Kolb H, Rathmann W, Giani G, Koenig W (2006) Sex differences in the relation of body composition to markers of inflammation. Atherosclerosis 184:216–224
Thorand B, Baumert J, Kolb H, Meisinger C, Chambless L, Koenig W, Herder C (2007) Sex differences in the prediction of type 2 diabetes by inflammatory markers: results from the MONICA/KORA Augsburg case-cohort study, 1984–2002. Diabetes Care 30:854–860
Voznesensky M, Walsh S, Dauser D, Brindisi J, Kenny AM (2009) The association between dehydroepiandosterone and frailty in older men and women. Age Ageing 38:401–406
Walston J, Hadley EC, Ferrucci L, Guralnik JM, Newman AB, Studenski SA, Ershler WB, Harris T, Fried LP (2006) Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. J Am Geriatr Soc 54:991–1001
Walston J, McBurnie MA, Newman A, Tracy RP, Kop WJ, Hirsch CH, Gottdiener J, Fried LP (2002) Frailty and activation of the inflammation and coagulation systems with and without clinical comorbidities: results from the Cardiovascular Health Study. Arch Intern Med 162:2333–2341