ALLOSTATIC LOAD AS A BIOLOGICAL SUBSTRATE TO INTRINSIC CAPACITY: A SECONDARY ANALYSIS OF CRELES
ALLOSTATIC LOAD AS A BIOLOGICAL SUBSTRATE TO INTRINSIC CAPACITY: A SECONDARY ANALYSIS OF CRELES
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DOI：
10.1007/s12603-019-1251-5
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发表时间：
2019-11-01
影响因子：
5.8
通讯作者：
Perez-Zepeda, M. U.
中科院分区：
文献类型：
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作者：
Gutierrez-Robledo, L. M.;Garcia-Chanes, R. E.;Perez-Zepeda, M. U.
目的：内在能力（Intrinsic capacity，IC）是积极老龄化的最新观点之一。在其目前的状态下，缺乏一个生物基板经得起干预。本研究的目的是确定非稳态负荷（AL）与IC的关联。设计：我们提出了一个横截面分析哥斯达黎加长寿和健康老龄化研究。背景：本报告来自哥斯达黎加老年人的代表性样本;中美洲地区一体化国家之一。参与者：2 827名60岁或以上的社区居民。方法：收集和验证IC指数，包括不同的领域：认知，心理，感觉，活力和运动。AL整合了：血压、腹部肥胖、体重指数、HDL-胆固醇、糖化血红蛋白、DHEAS、皮质醇、肾上腺素和去甲肾上腺素。根据异常生物标志物的数量（0-1、2-3和>= 4）将AL分为三类。慢性病、社会经济水平、性别和年龄为调节变量。有序逻辑回归模型进行了估计，以测试的关联强度。结果：在总共1，888人的样本中，51%（n=962）为女性，36.4%为60-69岁年龄组。IC指数的平均评分为6.6（2.2）。当与AL的参考组（0-1个异常生物标志物）相比时，对于具有2-3个异常AL生物标志物的那些组（OR 0.67，p=0.007）以及对于具有>= 4个异常AL生物标志物的那些组（OR 0.56，p=0.002），调整模型的优势比（OR）是显著的。结论和影响：AL与IC的相关性增加，即使调整了社会经济地位和慢性疾病等因素。靶向治疗AL可能会改善老年人的IC，从而减少残疾或明显依赖的进展。
Objectives: Intrinsic capacity (IC) is one of the latest views of positive aging. In its current status lacks a biological substrate amenable to be intervened. The aim of this study was to determine the association of allostatic load (AL) with IC. Design: We present a cross-sectional analysis of the Costa Rican Longevity and Healthy Aging Study. Setting: This report is from a representative sample of Costa Rican older adults; one of the countries that integrate the Central America region. Participants: 2,827, 60-year or older community-dwelling individuals. Methods: An IC index was gathered and validated, including different domains: cognitive, psychological, sensory, vitality and locomotion. AL was integrated with: blood pressure, abdominal obesity, body mass index, HDL-cholesterol, glycosylated hemoglobin, DHEAS, cortisol, epinephrine and norepinephrine. AL was grouped in three categories according to the number of abnormal biomarkers (0-1, 2-3 and >= 4). Chronic diseases, socioeconomic level, sex and age were the adjusting variables. Ordinal logistic regression models were estimated in order to test the strength of the association. Results: From a total sample of 1,888 individuals, 51% (n=962) were women, 36.4% were in the 60-69 age category. The mean score of the IC index was of 6.6 (2.2). Odds ratio (OR) of the adjusted models were significant for the group of those with 2-3 abnormal biomarkers of AL (OR 0.67, p=0.007) and also for those with >= 4 (OR 0.56, p=0.002), when compared to the reference group of AL (0-1 abnormal biomarkers). Conclusions and implications: AL showed an incremental association with IC, even when adjusted for factors such as socioeconomic status and chronic diseases. Targeting therapeutically AL could potentially improve IC in older adults and therefore decreasing the progression to disability or to overt dependency.