The Adiponectin Paradox in the Elderly: Associations With Body Composition, Physical Functioning, and Mortality
The Adiponectin Paradox in the Elderly: Associations With Body Composition, Physical Functioning, and Mortality
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DOI：
10.1093/gerona/gly017
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发表时间：
2019-02-01
影响因子：
5.1
通讯作者：
Harris, Tamara B.
中科院分区：
文献类型：
--
作者：
Baker, Joshua F.;Newman, Anne B.;Harris, Tamara B.
研究背景为确定脂联素水平是否与老年人的体重减轻、低肌肉质量和身体功能相关，并确定与残疾和死亡事件的独立关联，纳入了来自健康、衰老和身体组成研究的3，044名参与者，他们进行了全身双能吸收测定法，以评估非肥胖瘦体重指数（ALMI，kg/m2）和脂肪质量指数（FMI，kg/m2），大腿肌肉密度的计算机断层扫描测量，体重史，身体功能的估计，以及入组时的脂联素水平。脂联素水平与身体组成、体重减轻和身体功能之间的关系通过多变量线性回归模型进行评估。在中介分析中评估脂联素与事件残疾和死亡率之间的关联，调整其他factor.Results基线时脂联素水平较高与低FMI Z评分、低腰围、低ALMI Z评分、低肌肉密度、体重减轻史和身体功能差独立相关（所有p <0.05）。在校正人口统计学因素、肥胖和共病的模型中，更高的脂联素水平（每标准差）与事件残疾[HR：1.14（1.08，1.20），p < .001]和更高的死亡率[HR：1.17（1.10，1.25），p < .001]相关。当调整身体成分、肌肉密度、体重减轻和身体功能时，这种相关性完全减弱，不再显著（所有p > 0.05）。结论血清脂联素水平升高与既往体重减轻、低骨骼肌质量、低肌肉密度和身体功能不良有关。高脂联素与更大的意外残疾和死亡风险相关，但并非独立于这些因素。
Background To determine if adiponectin levels are associated with weight loss, low muscle mass, and physical functioning among the elderly and to determine independent associations with incident disability and death.Methods Included were 3,044 participants from the Health, Aging and Body Composition Study, who had whole-body dual energy absorptiometry performed to evaluate appendicular lean mass index (ALMI, kg/m(2)) and fat mass index (FMI, kg/m(2)), computed tomography measures of thigh muscle density, weight histories, estimates of physical functioning, and adiponectin levels at enrollment. Associations between adiponectin levels and body composition, weight loss, and physical functioning were assessed in multivariable linear regression models. Associations between adiponectin and incident disability and mortality were assessed in mediation analyses, adjusting for other factors.Results Greater adiponectin at baseline was independently associated with low FMI Z-score, lower waist circumference, low ALMI Z-score, low muscle density, a history of weight loss, and poor physical functioning (all p < .05). Greater adiponectin levels (per SD) were associated with incident disability [HR: 1.14 (1.08, 1.20), p < .001] and greater mortality [HR: 1.17 (1.10, 1.25), p < .001] in models adjusting for demographic factors, adiposity, and comorbid conditions. The association was completely attenuated and no longer significant (all p > 0.05) when adjusting for body composition, muscle density, weight loss, and physical functioning at baseline.Conclusions Greater serum adiponectin levels are associated with historical weight loss, low skeletal muscle mass, low muscle density, and poor physical functioning. High adiponectin is associated with a greater risk of incident disability and death, but not independently of these factors.