Inflammatory markers and longitudinal lung function decline in the elderly
Inflammatory markers and longitudinal lung function decline in the elderly
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DOI：
10.1093/aje/kwn174
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发表时间：
2008-09-15
影响因子：
5
通讯作者：
Barr, R. Graham
中科院分区：
文献类型：
--
作者：
Jiang, Rui;Burke, Gregory L.;Barr, R. Graham
检查炎症标志物纤维蛋白原和c反应蛋白（CRP）与肺功能下降之间关系的纵向研究很少。作者研究了纤维蛋白原和CRP水平升高是否与老年人纵向肺功能下降有关。心血管健康研究测量了1989-1990年或1992-1993年期间来自美国四个社区的5790名65岁及以上的白人和非裔美国人的纤维蛋白原和CRP。1989-1990年以及4年、7年和16年后进行肺量测定。在多种潜在混杂因素校正后，纤维蛋白原和CRP与肺功能基线呈负相关。在混合模型中，1秒用力呼气量(FEV1)/用力肺活量（FVC）比率随年龄增长的下降速度在基线纤维蛋白原较高的患者中更快（-0.032%/年每标准差较高的纤维蛋白原（95%置信区间：-0.057,-0.0074）），而在CRP较高的患者中则没有（-0.0037%/年每标准差较高的CRP(95%置信区间：-0.013,0.0056)）。FEV1和FVC的纵向分析结果与假设相反，可能是因为FEV1和FVC的死亡率高，且FEV1和FVC呈强负相关，但FEV1/FVC与死亡率无关。另一种处理缺失数据的方法也产生了类似的结果。综上所述，较高水平的纤维蛋白原，而不是CRP，独立预测老年人FEV1/FVC的下降。
Longitudinal studies examining associations of the inflammatory markers fibrinogen and C-reactive protein (CRP) with lung function decline are sparse. The authors examined whether elevated fibrinogen and CRP levels were associated with greater longitudinal lung function decline in the elderly. The Cardiovascular Health Study measured fibrinogen and CRP in 5,790 Whites and African Americans from four US communities aged 65 years or older in 1989-1990 or 1992-1993. Spirometry was performed in 1989-1990 and 4, 7, and 16 years later. Fibrinogen and CRP were inversely associated with lung function at baseline after adjustment for multiple potential confounders. In mixed models, the rate of decline in forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio with increasing age was faster among those with higher baseline fibrinogen (-0.032%/year per standard deviation higher fibrinogen (95% confidence interval: -0.057, -0.0074)) but not among those with higher CRP (-0.0037%/year per standard deviation higher CRP (95% confidence interval: -0.013, 0.0056)). Longitudinal analyses for FEV1 and FVC yielded results in the direction opposite of that hypothesized, possibly because of the high mortality rate and strong inverse association of FEV1 and FVC but not FEV1/FVC with mortality. An alternative approach to missing data yielded similar results. In conclusion, higher levels of fibrinogen, but not CRP, independently predicted greater FEV1/FVC decline in the elderly.