Diabetes, inflammation, and functional decline in older adults - Findings from the health, aging and body composition (ABC) study
Diabetes, inflammation, and functional decline in older adults - Findings from the health, aging and body composition (ABC) study
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DOI：
10.2337/dc06-0245
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发表时间：
2006-09-01
期刊：
影响因子：
16.2
通讯作者：
Harris, Tamara B.
中科院分区：
文献类型：
--
作者：
Figaro, M. Kathleen;Kritchevsky, Stephen B.;Harris, Tamara B.
目的：年龄、糖尿病和炎症标志物升高独立增加功能下降的风险.我们研究了C-反应蛋白（CRP）和白细胞介素-6（IL-6）的影响，在老年人和无diabetes. RESEARCH设计和方法-我们分析了数据从一个队列的2,895年功能良好的成年人年龄在70-79岁，随后为发展持续的功能限制超过3.5年。根据空腹血糖和/或降糖药物使用情况评估参与者是否存在糖尿病，并根据CRP或IL-6水平将其分为三个相等的组（三分位数）。持续的功能限制被定义为困难爬10步或行走四分之一英里的两个连续半年assessment.RESULTS -在基线，702名参与者（24%）有糖尿病。正常血糖组和糖尿病组的CRP值分别为2.8-4.4和3.7-5.4（P < 0.001）。在糖尿病患者中，与CRP和IL-6水平升高相关的功能受限的未校正发生率更高。在调整临床和人口统计学协变量后，对于糖尿病患者和非糖尿病患者，CRP或IL-6最高三分位数的持续功能限制大于最低三分位数。CRP风险比（HR）分别为1.7（95% CI 1.2-2.3）和1.4（1.1-1.6）。IL-6 HR分别为1.8（1.3-2.5）和1.6（1.4-2.0），respectively.CONCLUSIONS -在最初的高功能老年人中，糖尿病和高炎症负荷的患者功能下降的风险增加。在早期阶段进行干预以减少炎症可能会保护这些个体的功能。
OBJECTIVE - Age, diabetes, and elevated inflammatory markers independently increase the risk of functional decline. We examined the effect of C-reactive protein (CRP) and interleukin-6 (IL-6) on the incident mobility limitation in older adults with and without diabetes.RESEARCH DESIGN AND METHODS - We analyzed data from a cohort of 2,895 well-functioning adults aged 70-79 years, followed for development of persistent functional limitation over 3.5 years. Participants were assessed for the presence of diabetes according to fasting glucose and/or hypoglycemic medication use and were divided into three equal groups (tertiles) according to level of CRP or IL-6. Persistent functional limitation was defined as difficulty climbing 10 steps or walking one-quarter mile on two consecutive semiannual assessments.RESULTS - At baseline, 702 participants (24%) had diabetes. CRP values were (median SD) 2.8-4.4 versus 3.7-5.4 for those with normal glucose and diabetes, respectively (P < 0.001). The unadjusted incidence of functional limitation associated With increased levels of CRP and IL-6 was greater among participants with diabetes. After adjusting for clinical and demographic covariates, persistent functional limitation for the highest tertile was greater compared with that for the lowest tertile of CRP or IL-6 for those with and without diabetes. CRP hazard ratios (HRs) were 1.7 (95% CI 1.2-2.3) versus 1.4 (1.1-1.6), respectively. IL-6 HRs were 1.8 (1.3-2.5) versus 1.6 (1.4-2.0), respectively.CONCLUSIONS - In initially high-functioning older adults, those with diabetes and higher inflammatory burden had an increased risk of functional decline. interventions at early stages to reduce inflammation may preserve function in these individuals.