RESULTS: Among 996 participants (mean age 62 years, range 40 to 88 years, 52% female), the 19-year survival rate was 65%. Adjusting for age, sex, and cytomegalovirus (CMV) serostatus, higher CD4/CD8 and Tc17/CD8 + Treg ratios were significantly associated with lower all-cause mortality (HR: 0.86 [0.76-0.96], 0.84 [0.74-0.94], respectively), while higher CD8 regulatory cell levels (CD8 + CD25 + FoxP3 +) were associated with increased all-cause mortality risk (HR = 1.17, [1.03-1.32]). Elevated IL-6 levels correlated with higher all-cause, cardiovascular, and non-cardiovascular mortality (HR = 1.43 [1.26-1.62], 1.70 [1.31-2.21], and 1.36 [1.18-1.57], respectively). However, after adjusting for cardiovascular risk factors and prevalent cancer alongside age, sex, and CMV, immune cell phenotypes were no longer associated with mortality in our cohort. Nonetheless, IL-6 remained significantly associated with all-cause and cardiovascular mortality (HRs: 1.3 [1.13-1.49], 1.5 [1.12-1.99], respectively).
CONCLUSIONS: In 19-year follow-up, higher Tc17/CD8 + Treg and CD4/CD8 ratios were associated with lower all-cause mortality, while the CD8 + CD25 + FoxP3 + (CD8 + Treg) phenotype showed increased risk. Elevated IL-6 levels consistently correlated with amplified mortality risks. These findings highlight the links between immune phenotypes and mortality, suggesting implications for future research and clinical considerations.
结果:在996名参与者中(平均年龄62岁,40到88年,52%女性),19年生存率为65%.调整年龄,性别,和巨细胞病毒(CMV)血清状态,较高的CD4/CD8和Tc17/CD8+Treg比率与较低的全因死亡率显著相关(HR:0.86[0.76-0.96],0.84[0.74-0.94],分别),而较高的CD8调节细胞水平(CD8+CD25+FoxP3+)与全因死亡风险增加相关(HR=1.17,[1.03-1.32]).IL-6水平升高与全因升高相关,心血管,和非心血管死亡率(HR=1.43[1.26-1.62],1.70[1.31-2.21],和1.36[1.18-1.57],分别)。然而,在调整了心血管危险因素和流行的癌症后,性别,和CMV,在我们的队列中,免疫细胞表型与死亡率不再相关.尽管如此,IL-6仍然与全因死亡率和心血管死亡率显著相关(HR:1.3[1.13-1.49],1.5[1.12-1.99],分别)。
结论:在19年的随访中,较高的Tc17/CD8+Treg和CD4/CD8比值与较低的全因死亡率相关,而CD8+CD25+FoxP3+(CD8+Treg)表型显示风险增加。IL-6水平升高与死亡风险增加一致相关。这些发现强调了免疫表型和死亡率之间的联系,建议对未来研究和临床考虑的影响。