Change in muscle strength explains accelerated decline of physical function in older women with high interleukin-6 serum levels
Change in muscle strength explains accelerated decline of physical function in older women with high interleukin-6 serum levels
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DOI：
10.1046/j.1532-5415.2002.50605.x
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发表时间：
2002-12-01
影响因子：
6.3
通讯作者：
Guralnik, JM
中科院分区：
文献类型：
--
作者：
Ferrucci, L;Penninx, BWJH;Guralnik, JM
目的：测试在许多研究中发现的炎症和残疾之间的前瞻性关联中，血清白介素6水平高的老年人加速的骨质疏松症是否起作用。设计：对中重度残疾的老年妇女进行的队列研究。伙伴：妇女健康和老龄化研究中的620名老年妇女，她们可以获得基线血清IL-6水平的信息。测量：在基线和超过6次每半年一次的随访中评估功能状态的自我报告、行走能力的客观测量和膝关节伸肌力量。潜在的混杂因素是基线年龄、种族、体重指数、吸烟、抑郁和医疗条件。结果：在基线水平，IL-6升高的女性更容易残疾，行走速度较慢。在调整混杂因素后，IL-6水平最高的三分位数(IL-6和GT；3.10pg/mL)的女性发生意外活动障碍(风险比(RR)=1.50，95%可信区间(CI)=1.01-2.27)、日常生活能力障碍(RR=1.41，95%CI=1.01-1.98)和严重行走受限(RR=1.61，95%CI=1.09-2.38)的风险更高，步行速度下降更剧烈(P<；.001)高于IL-6最低三分位数(IL-6≤1.78pg/mL)的女性。膝关节伸展力量的下降幅度也更大，但IL-6组之间的差异并不显著。在调整了膝关节伸肌力量随时间的变化后，高IL-6与身体功能加速下降之间的关联不再具有统计学意义。结论：血清IL-6水平高的老年女性发生肢体残疾的风险更高，行走能力下降的幅度更大，部分原因是肌肉力量的平行下降。
OBJECTIVES: To test whether accelerated sarcopenia in older persons with high interleukin (IL)-6 serum levels plays a role in the prospective association between inflammation and disability found in many studies.DESIGN: Cohort study of older women with moderate to severe disability.PARTICIPANTS: Six hundred twenty older women from the Women's Health and Aging Study in whom information on baseline IL-6 serum level was available.MEASURMENTS: Self-report of functional status, objective measures of walking performance, and knee extensor strength were assessed at baseline and over six semiannual follow-up visits. Potential confounders were baseline age, race, body mass index, smoking, depression, and medical conditions.RESULTS: At baseline, women with high IL-6 were more often disabled and had lower walking speed. After adjusting for confounders, women in the highest IL-6 tertile (IL-6 > 3.10 pg/mL) were at higher risk of developing incident mobility disability (risk ratio (RR) = 1.50, 95% confidence interval (CI) = 1.01-2.27), disability in activities of daily living (RR = 1.41, 95% CI = 1.01-1.98), and severe limitation in walking (RR = 1.61, 95% CI = 1.09-2.38) and experienced steeper declines in walking speed (P < .001) than women in the lowest IL-6 tertile (IL-6 ≤1.78 pg/mL). Decline in knee extensor strength was also steeper, but differences across IL-6 tertiles were not significant. After adjusting for change over time in knee extensor strength, the association between high IL-6 and accelerated decline of physical function was no longer statistically significant.CONCLUSIONS: Older women with high IL-6 serum levels have a higher risk of developing physical disability and experience a steeper decline in walking ability than those with lower levels, which are partially explained by a parallel decline in muscle strength.