Biomarkers of inflammation and malnutrition associated with early death in healthy elderly people
Biomarkers of inflammation and malnutrition associated with early death in healthy elderly people
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DOI：
10.1111/j.1532-5415.2008.01677.x
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发表时间：
2008-05-01
影响因子：
6.3
通讯作者：
Delcourt, Cecile
中科院分区：
文献类型：
--
作者：
Carriere, Isabelle;Dupuy, Anne-Marie;Delcourt, Cecile
目的：确定营养不良和炎症生物标志物是否可预测健康老年受试者的全因死亡率、癌症死亡率和心血管疾病死亡率。
设计：基于人群的研究，前瞻性队列研究。
地点：法国地中海沿岸的塞特。
参与者：来自与年龄相关眼病队列的553名男性和888名60岁及以上无已知合并症的女性。
测量：在基线时测量血浆胆固醇、白蛋白、转甲状腺素蛋白（TTR）、C - 反应蛋白（CRP）和α1 - 酸性糖蛋白（AAG）水平。为了研究5年（早期）和5 - 9年（晚期）死亡率的风险，使用考克斯模型评估风险比（HR）。
结果：在男性中，早期死亡与高CRP和AAG以及低白蛋白和TTR相关。在女性中，早期死亡与高AAG、低TTR和低胆固醇相关。对于晚期死亡，男性中唯一显著的关联是与CRP相关。在炎症生物标志物和营养不良之间观察到协同效应。在男性中，CRP处于最高四分位数且白蛋白处于最低四分位数时，早期死亡的调整后HR为4.98（95%置信区间（CI）= 2.25 - 11.01）。在男性中，AAG处于最高四分位数且TTR处于最低四分位数时，这种风险最大（HR = 6.86，95% CI = 3.20 - 14.71）。在女性中，AAG处于最高四分位数且TTR处于最低四分位数时，这种风险最大（HR = 4.64，95% CI = 1.79 - 12.05）。男性中高CRP和AAG以及低白蛋白和TTR的癌症死亡率较高，但女性中并非如此。
结论：炎症生物标志物和营养不良共同预测早期死亡率。在健康老年受试者中，TTR和AAG可能有助于识别死亡风险较高的老年受试者。
OBJECTIVES: To determine whether malnutrition and biomarkers of inflammation predict all-cause, cancer, and cardiovascular mortality in healthy elderly subjects.DESIGN: Population-based study, prospective cohort.SETTING: Sete, on the French Mediterranean coast.PARTICIPANTS: Five hundred and fifty-three men and 888 women aged 60 and older from the Pathologies Oculaires Liees a l'Age cohort free of known comorbidities.MEASUREMENTS: Plasma levels of cholesterol, albumin, transthyretin (TTR), C-reactive protein (CRP), and alpha 1-acid glycoprotein (AAG) were measured at baseline. To investigate the risks of 5-year (early) and 5- to 9-year (late) mortality, hazard ratios (HR) were evaluated using Cox models.RESULTS: In men, early death was associated with high CRP and AAG and low albumin and TTR. In women, early death was associated with high AAG, low TTR and low cholesterol. For late death, the only significant association was with CRP in men. A synergistic effect was observed between biomarkers of inflammation and malnutrition. In men, the adjusted HR of early death was 4.98 (95% confidence interval (CI)=2.25-11.01) for both CRP in the highest quartile and albumin in the lowest. In men, this risk was greatest for both AAG in the highest quartile and TTR in the lowest (HR=6.86, 95% CI=3.20-14.71). In women, this risk was greatest for both AAG in the highest quartile and TTR in the lowest (HR=4.64, 95% CI=1.79-12.05). Cancer mortality was greater for high CRP and AAG and for low albumin and TTR in men but not in women.CONCLUSION: Biomarkers of inflammation and malnutrition together predict early mortality. In healthy elderly subjects, TTR and AAG could be helpful in identifying elderly subjects at higher risk of death.