Association of C-reactive protein and interleukin-6 with new-onset fatigue in the Whitehall II prospective cohort study.
Association of C-reactive protein and interleukin-6 with new-onset fatigue in the Whitehall II prospective cohort study.
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DOI：
10.1017/s0033291712002437
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发表时间：
2013-08
影响因子：
6.9
通讯作者：
Irwin MR
中科院分区：
文献类型：
--
作者：
Cho HJ;Kivimäki M;Bower JE;Irwin MR
尽管对神经免疫相互作用的基础研究表明，炎症过程可能在疲劳的发展中发挥作用，但关于这种联系的基于人群的证据是有限的。这项研究检测了血浆C-反应蛋白(CRP)和白介素6(IL-6)这两个全身炎症的生物标志物是否可以预测疲劳的发生。白厅II研究是一项在伦敦20个公务员部门进行的大规模队列研究。对4847名非疲劳受试者在第三阶段(1991-1993年，年龄39-63岁)进行了血浆CRP和IL-6的测定。在第三阶段和第四阶段(1995-1996年)，使用36项简明健康调查(SF-36)的活力子量表评估疲劳。在平均3.1年的随访中，957例新的疲劳病例(19.7%)被确定为使用活力分量表中预先设定的50分或更低的分界值。根据疾病控制中心/美国心脏协会的建议，CRP值分为低(≥1.0 mg/L)或高(CRP1.0 mg/L)。同样，IL-6的值也分为低(-lt；1.5pg/m l)和高(≥1.5pg/m l)。在充分调整社会人口学和生物行为协变量后，高C反应蛋白组和高IL-6组新发疲劳的优势比分别为1.28(95%可信区间1.09~1.49，P=0.003)和1.24(1.06~1.45，P=0.008)。当将CRP和IL-6作为连续变量处理时，也发现了类似的结果。血浆中的CRP和IL-6可能与新发疲劳有关，这支持了低度炎症在疲劳发生中起作用的假说。
Although basic research on neuroimmune interactions suggests that inflammatory processes may play a role in the development of fatigue, population-based evidence on this association is limited. This study examined whether plasma C-reactive protein (CRP) and interleukin-6 (IL-6), biomarkers of systemic inflammation, predict fatigue onset. The Whitehall II study is a large-scale cohort study conducted in 20 civil service departments in London. Plasma CRP and IL-6 were measured in 4847 non-fatigued participants at Phase 3 (1991-1993, ages 39-63 years). Fatigue was assessed using the Vitality Subscale of the 36-item Short Form Health Survey (SF-36) at Phase 3 and Phase 4 (1995-1996). During a mean follow-up of 3.1 years, 957 new fatigue cases (19.7%) were identified using the pre-established cutoff score 50 or less on the Vitality Subscale. CRP values were dichotomized as low (<1.0 mg/L) or high (≥1.0 mg/L) using the Centers for Disease Control/American Heart Association recommendations. Similarly, IL-6 values were also dichotomized as low (<1.5 pg/mL) or high (≥1.5 pg/mL). After full adjustment for sociodemographic and biobehavioral covariates, the odds ratios for new-onset fatigue were 1.28 (95% confidence interval 1.09-1.49, P=0.003) for high CRP and 1.24 (1.06-1.45, P=0.008) for high IL-6. Similar results were found when CRP and IL-6 were treated as continuous variables. Plasma CRP and IL-6 were prospectively associated with new-onset fatigue, supporting the hypothesis that low-grade inflammation has a role in the development of fatigue.