Influence of Long-term Nonaspirin NSAID Use on Risk of Frailty in Men ≥60 Years: The Physicians' Health Study.
Influence of Long-term Nonaspirin NSAID Use on Risk of Frailty in Men ≥60 Years: The Physicians' Health Study.
复制标题
长期使用非那司匹林 NSAID 对男性 60 年后虚弱风险的影响：医生健康研究。
DOI：
10.1093/gerona/glac006
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Driver,JaneA
中科院分区：
文献类型：
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作者：
Orkaby,ArielaR;Ward,Rachel;Chen,Jiaying;Shanbhag,Akshay;Sesso,HowardD;Gaziano,JMichael;Djousse,Luc;Driver,JaneA
背景炎症是导致虚弱的一个重要途径，但常用的非阿司匹林类非甾体抗炎药（nonsteroidalanti-inflammatory drugs，NSAIDs）是否能预防虚弱尚不清楚。年度问卷收集了关于NSAID使用、生活方式和发病率的数据。平均每年NSAID使用分为0天/年、1-12天/年、13-60天/年和>60天/年。使用经验证的33项虚弱指数评估虚弱。倾向评分的治疗加权逆概率被用来解决混杂的适应症和logistic回归模型估计的优势比（OR）的普遍脆弱根据nonaspirin非甾体抗炎药use.ResultsA共12 101男性医生（平均年龄70 ± 7岁，平均随访11年）。报告的NSAID使用为0天/年（2 234例），1-12天/年（5 812例），13-60天/年（2 833例），>60天/年（1 222例）。共有2413名参与者（20%）身体虚弱。自我报告的非甾体抗炎药使用量较高与饮酒、吸烟、关节炎、高血压和心脏病增加有关，而非甾体抗炎药使用量较少与使用香豆素和既往出血有关。倾向评分调整后，所有特征均达到平衡。ORS（95%置信区间）的患病率为0.90（0.80-1.02）、1.02（0.89-1.17）和1.26（1.07-1.49）平均NSAID使用1-12天/年、13-60天/年和>60天/年，与0天/年相比（p趋势<0.001）。结论长期高频率使用NSAID与老年男性虚弱风险增加相关。需要进一步的研究来了解抗炎药物在老年人中的作用及其对整体健康的影响。
BackgroundInflammation is a central pathway leading to frailty but whether commonly used nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can prevent frailty is unknown.MethodsProspective cohort study of male physicians ≥60 who participated in the Physicians’ Health Study. Annual questionnaires collected data on NSAID use, lifestyle, and morbidity. Average annual NSAID use was categorized as 0 days/year, 1–12 days/year, 13–60 days/year, and >60 days/year. Frailty was assessed using a validated 33-item frailty index. Propensity score inverse probability of treatment weighting was used to address confounding by indication and logistic regression models estimated odds ratios (ORs) of prevalent frailty according to nonaspirin NSAID use.ResultsA total of 12 101 male physicians were included (mean age 70 ± 7 years, mean follow-up 11 years). Reported NSAID use was 0 days/year for 2 234, 1–12 days/year for 5 812, 13–60 days/year for 2 833, and >60 days/year for 1 222 participants. A total of 2 413 participants (20%) were frail. Higher self-reported NSAID use was associated with greater alcohol use, smoking, arthritis, hypertension, and heart disease, while less NSAID use was associated with coumadin use and prior bleeding. After propensity score adjustment, all characteristics were balanced. ORs (95% confidence intervals) of prevalent frailty were 0.90 (0.80–1.02), 1.02 (0.89–1.17), and 1.26 (1.07–1.49) for average NSAID use of 1–12 days/year, 13–60 days/year, and >60 days/year, compared to 0 days/year (p-trend < .001).ConclusionsLong-term use of NSAIDs at high frequency is associated with increased risk of frailty among older men. Additional study is needed to understand the role of anti-inflammatory medication in older adults and its implication for overall health.