Linking C-reactive protein to late-life disability in the National Health and Nutrition Examination Survey (NHANES) 1999-2002
Linking C-reactive protein to late-life disability in the National Health and Nutrition Examination Survey (NHANES) 1999-2002
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DOI：
10.1093/gerona/61.4.380
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发表时间：
2006-04-01
影响因子：
5.1
通讯作者：
Leveille, SG
中科院分区：
文献类型：
--
作者：
Kuo, HK;Bean, JF;Leveille, SG
背景通过白细胞介素-6测量的慢性炎症可预测老年人的偶发残疾。然而，关于C反应蛋白（CRP）与残疾的关系却知之甚少。参与者（> 60岁，N = 1680）来自1999-2002年国家健康和营养调查。通过自我报告获得日常生活活动（ADL）、工具性日常生活活动（IADL）、休闲和社交活动（LSA）、下肢活动（LEM）和一般体力活动（GPA）的残疾。峰值肌肉力量是等速峰值腿部扭矩和峰值力速度的乘积。通过习惯性步行速度评估功能限制，该速度从20英尺计时步行中获得。采用乳胶增强散射比浊法定量测定CRP水平。CRP水平升高与IADL、LSA、LEM和GPA的残疾相关，独立于基本人口统计学、慢性医学疾病、健康行为以及营养标志物。自然对数转换CRP的每一个标准差增加的残疾相应比值比分别为1.18（95%置信区间[CI]，1.02-1.35）、1.18（95% CI，1.00-1.39）、1.17（95% CI，1.03-1.33）和1.17（95% CI，1.05-1.31）。在额外调整腿力、力量和/或步行速度后，这种关系减弱，这意味着腿力的损伤和步态速度的限制可能介导CRP和残疾之间的关联。CRP与腿部力量和步行速度呈负相关。同样地，对腿部力量的额外调整实质上减少了CRP和步行速度之间的关联，表明CRP和步态速度之间的力量中介作用。独立于慢性疾病，CRP升高通过肌肉力量、习惯性步态速度或两者的介导与多个残疾领域相关。未来的研究需要了解CRP是老年人群残疾的危险因素。
Background. Chronic inflammation, measured by interleukin-6, predicts incident disability among elderly people. However, little is known about the relation of C-reactive protein (CRP) to disability.Method. participants (> 60 years old, N = 1680) were from the National Health and Nutrition Examination Survey 1999-2002. Disability in activities of daily living (ADL), instrumental activities of daily living (IADL), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activities (GPA) was obtained by self-report. Peak muscle power was the product of isokinetic peak leg torque and peak force velocity. Functional limitations were evaluated via habitual walking speed, which was obtained from a 20-foot timed walk. CRP levels were quantified by using latex-enhanced nephelometry.Results. Elevated CRP levels were associated with disability in IADL, LSA, LEM, and GPA, independent of basic demographics, chronic medical diseases, health behaviors, as well as nutritional markers. The corresponding odds ratios of disability for each standard-deviation increase in natural-log-transformed CRP were 1.18 (95% confidence interval [CI], 1.02-1.35), 1.18 (95% CI, 1.00-1.39), 1.17 (95% CI, 1.03-1.33), and 1.17 (95% CI, 1.05-1.31), respectively. The relationship diminished after additional adjustment of let, power and/or walking speed, meaning that impairment in leg power and limitations in gait speed likely mediate the association between CRP and disability. CRP had an inverse relationship to leg power and walking speed. Likewise, additional adjustment for leg power substantially diminished the association between CRP and walking speed, suggesting a mediating effect of power between CRP and gait speed.Conclusions. Independent of chronic diseases, elevated CRP is associated with multiple domains of disability through mediation of muscle power, habitual gait speed, or both. Future research is needed to understand CRP its a risk factor for disability in older populations.