Coagulation and activation of inflammatory pathways in the development of functional decline and mortality in the elderly
Coagulation and activation of inflammatory pathways in the development of functional decline and mortality in the elderly
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DOI：
10.1016/s0002-9343(02)01484-5
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发表时间：
2003-02-15
影响因子：
5.9
通讯作者：
Pieper, CF
中科院分区：
文献类型：
--
作者：
Cohen, HJ;Harris, T;Pieper, CF
目得：进行这项研究，以确定炎症标志物（白细胞介素6）和凝血（D-二聚体）对老年人的死亡率和功能状态的影响。方法：受试者被选定为杜克建立人口的老年人流行病学研究。在1992年，2569名受试者（年龄> 71岁）接受了采访，其中1723人进行了白细胞介素-6和D-二聚体测量。白细胞介素6和D-二聚体的值分为四分位数。结局为死亡率（5年）和功能状态（4年）。结果：死亡的相对危险度为1.28（95%置信区间[Cl]：0.98至1.69; P = 0.06）对于仅白细胞介素-6水平处于最高四分位数的患者，1.53（95%CI：1.18 - 1.97; P = 0.001），而两者均在最高四分位数的受试者，与不在最高四分位数的受试者相比，D-二聚体水平为2.00（95%CI：1.53 - 2.62;P = 0.0001）。那些高白细胞介素-6和高D-二聚体水平的最大的下降，在所有措施的function.CONCLUSION：激活凝血和炎症途径与死亡率和功能下降，并可能是一个脆弱的表型在老年人的发展的解释的一部分。(C)2003年，Excerpta Medica Inc.
PURPOSE: This study was performed to determine the effects of markers of inflammation (interleukin 6) and coagulation (D-dimer) on mortality and functional status in older persons.METHODS: Subjects were selected for the Duke Established Populations for Epidemiologic Studies of the Elderly. In 1992, 2569 subjects, (age > 71 years) were interviewed, of whom 1723 had interleukin-6 and D-dimer measurements. Values of interleukin 6 and D-dimer were categorized into quartiles. Outcomes were mortality (through 5 years) and functional status (through 4 years). Relative risks were estimated with proportional hazards models that adjusted for potential confounders.RESULTS: The relative risk of mortality was 1.28 (95% confidence interval [Cl]: 0.98 to 1.69; P = 0.06) for those with only interleukin-6 levels in the highest quartile, 1.53 (95%CI: 1.18 to 1.97; P = 0.001) for subjects with only D-dimer levels in the highest quartile, and 2.00 (95% CI: 1.53 to 2.62;P = 0.0001) for those with levels of both in the highest quartile, as compared with those who were not in either of the highest quartiles. Those with high interleukin-6 and high D-dimer levels had the greatest declines in all measures of function.CONCLUSION: Activation of the coagulation and inflammatory pathways is associated with mortality and decline in function, and may be part of the explanation for the development of a frailty phenotype in the elderly. (C) 2003 by Excerpta Medica Inc.