TY - JOUR
T1 - Longitudinal changes in adiponectin and inflammatory markers and relation to survival in the oldest old
T2 - The cardiovascular health study all stars study
AU - Kizer, Jorge R.
AU - Arnold, Alice M.
AU - Jenny, Nancy S.
AU - Cushman, Mary
AU - Strotmeyer, Elsa S.
AU - Ives, Diane G.
AU - Ding, Jingzhong
AU - Kritchevsky, Stephen B.
AU - Chaves, Paulo H.M.
AU - Hirsch, Calvin H.
AU - Newman, Anne B.
N1 - Funding Information:
National Institute on Aging (AG-023629 to CHS All Stars Study); the National Heart, Lung, and Blood Institute with additional contribution from the National Institute of Neurological Disorders and Stroke (http://www.chs-nhlbi.org/pi.htm) (contract numbers N01-HC-85079 through N01-HC-85086, N01-HC-35129, N01 HC-15103, N01 HC-55222, N01-HC-75150, and N01-HC-45133 and grant number U01 HL080295 to CHS); the National Institute on Aging (R01 AG-15928, R01 AG-20098, and AG-027058); National Heart, Lung and Blood Institute (R01 HL-075366); the University of Pittsburgh Claude. D. Pepper Older Americans Independence Center (P30-AG-024827 to A.B.N.); National Heart, Lung and Blood Institute (K23 HL-070854 and R01 HL-094555 to J.R.K.).
PY - 2011/10
Y1 - 2011/10
N2 - Background. Adiponectin has anti-inflammatory properties, and its production is suppressed by inflammatory factors. Although elevated levels of adiponectin and inflammatory markers each predict mortality in older adults, the implications of their interdependent actions have not been examined.Methods. We investigated the joint associations of levels and interval changes in adiponectin, C-reactive protein (CRP), and interleukin 6 (IL-6) with risk of death in 840 older adults participating in a population-based study. Adiponectin, CRP, and IL-6 were measured in samples collected 8.9 (8.2-9.8) years apart, and all-cause mortality was subsequently ascertained (n = 176).Results.Interval changes and end levels of adiponectin, CRP, and IL-6 showed mostly positive, independent associations with mortality, without evidence of multiplicative interaction. Joint models, however, showed an U-shaped relationship between end level of adiponectin and outcome (hazard ratio [HR] [95% CI] = 0.72 [0.52-0.99] per standard deviation [SD] for levels <20.0 mg/L; HR = 1.91 [1.61-3.44] per SD for levels ≥20.0 mg/L). Participants with the greatest longitudinal increases (upper quartile) in both adiponectin and inflammatory markers had a higher risk of death (HR = 2.85 [1.78-4.58]) than those with large increases in adiponectin alone (HR = 1.87 [1.20-2.92]) (p =. 043), but not inflammatory markers alone (HR = 2.48 [1.67-3.67]) (p =. 55), as compared with smaller changes for both.Conclusion. Higher levels or interval change in adiponectin and inflammatory markers predict increased mortality in older persons independent of each other, although for adiponectin, the association appears inverse below 20 mg/L. These findings suggest that inflammatory and noninflammatory mechanisms governing aging-related decline operate in parallel and provide a potential explanation for paradoxical adiponectin-outcome associations reported previously.
AB - Background. Adiponectin has anti-inflammatory properties, and its production is suppressed by inflammatory factors. Although elevated levels of adiponectin and inflammatory markers each predict mortality in older adults, the implications of their interdependent actions have not been examined.Methods. We investigated the joint associations of levels and interval changes in adiponectin, C-reactive protein (CRP), and interleukin 6 (IL-6) with risk of death in 840 older adults participating in a population-based study. Adiponectin, CRP, and IL-6 were measured in samples collected 8.9 (8.2-9.8) years apart, and all-cause mortality was subsequently ascertained (n = 176).Results.Interval changes and end levels of adiponectin, CRP, and IL-6 showed mostly positive, independent associations with mortality, without evidence of multiplicative interaction. Joint models, however, showed an U-shaped relationship between end level of adiponectin and outcome (hazard ratio [HR] [95% CI] = 0.72 [0.52-0.99] per standard deviation [SD] for levels <20.0 mg/L; HR = 1.91 [1.61-3.44] per SD for levels ≥20.0 mg/L). Participants with the greatest longitudinal increases (upper quartile) in both adiponectin and inflammatory markers had a higher risk of death (HR = 2.85 [1.78-4.58]) than those with large increases in adiponectin alone (HR = 1.87 [1.20-2.92]) (p =. 043), but not inflammatory markers alone (HR = 2.48 [1.67-3.67]) (p =. 55), as compared with smaller changes for both.Conclusion. Higher levels or interval change in adiponectin and inflammatory markers predict increased mortality in older persons independent of each other, although for adiponectin, the association appears inverse below 20 mg/L. These findings suggest that inflammatory and noninflammatory mechanisms governing aging-related decline operate in parallel and provide a potential explanation for paradoxical adiponectin-outcome associations reported previously.
KW - Adiponectin
KW - Aging
KW - C-reactive protein
KW - Interleukin 6
KW - Mortality
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U2 - 10.1093/gerona/glr098
DO - 10.1093/gerona/glr098
M3 - Article
C2 - 21659339
AN - SCOPUS:80052903187
SN - 1079-5006
VL - 66 A
SP - 1100
EP - 1107
JO - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
JF - Journals of Gerontology - Series A Biological Sciences and Medical Sciences
IS - 10
ER -