Abstract：
OBJECTIVE: Frailty is a common health state that is closely linked to adverse health outcomes in aging society. Although many inflammatory biomarkers have been cross-sectionally associated with frailty, knowledge on the longitudinal association is still limited. This study investigated the associations between inflammatory factors in clinical practice and frailty progression over time.
METHODS: To investigate the associations of three common inflammatory markers (hypersensitive C-reactive protein [hsCRP], white blood cell [WBC] and fibrinogen) with the progression of frailty.
METHODS: Data of 2316 participants (age 67.9 ± 6.1 years) were obtained from the English longitudinal study of aging (wave 4, 6 and 8) over an 8-year follow-up. The frailty index (FI) was calculated from 52 items. Mixed-effects models and Cox proportional hazards (Cox-PH) models were used to analyze the associations of hsCRP, WBC and fibrinogen with frailty progression. Values of inflammatory biomarkers were log-transformed. Age, sex and gross wealth were controlled.
RESULTS: Mixed-effects models showed that at a cross-sectional level, higher levels of hsCRP (β: 0.007, 95% CI 0.004-0.010), WBC (β: 0.021, 95% CI 0.010-0.032) and fibrinogen (β: 0.022, 95% CI 0.005-0.038) were associated with greater FI values while no significant time interaction was found. Cox-PH models showed that higher baseline levels of hsCRP (HR: 1.10, 95% CI 1.03-1.17) and WBC (HR: 1.23, 95% CI 1.10-1.37) were linked to a greater risk of developing frailty within 8 years.
CONCLUSIONS: We concluded that hsCRP, WBC and fibrinogen can reflect frailty status at a cross-sectional level while only hsCRP and WBC are associated with frailty progression over an 8-year period.
METHODS: To investigate the associations of three common inflammatory markers (hypersensitive C-reactive protein [hsCRP], white blood cell [WBC] and fibrinogen) with the progression of frailty.
METHODS: Data of 2316 participants (age 67.9 ± 6.1 years) were obtained from the English longitudinal study of aging (wave 4, 6 and 8) over an 8-year follow-up. The frailty index (FI) was calculated from 52 items. Mixed-effects models and Cox proportional hazards (Cox-PH) models were used to analyze the associations of hsCRP, WBC and fibrinogen with frailty progression. Values of inflammatory biomarkers were log-transformed. Age, sex and gross wealth were controlled.
RESULTS: Mixed-effects models showed that at a cross-sectional level, higher levels of hsCRP (β: 0.007, 95% CI 0.004-0.010), WBC (β: 0.021, 95% CI 0.010-0.032) and fibrinogen (β: 0.022, 95% CI 0.005-0.038) were associated with greater FI values while no significant time interaction was found. Cox-PH models showed that higher baseline levels of hsCRP (HR: 1.10, 95% CI 1.03-1.17) and WBC (HR: 1.23, 95% CI 1.10-1.37) were linked to a greater risk of developing frailty within 8 years.
CONCLUSIONS: We concluded that hsCRP, WBC and fibrinogen can reflect frailty status at a cross-sectional level while only hsCRP and WBC are associated with frailty progression over an 8-year period.
摘要：
目的：虚弱是一种常见的健康状况，与老龄化社会的不良健康结果密切相关。尽管许多炎症生物标志物在横截面上与虚弱相关，关于纵向关联的知识仍然有限。这项研究调查了临床实践中炎性因子与随时间推移的虚弱进展之间的关联。
方法：为了研究三种常见的炎症标志物（超敏C反应蛋白[hsCRP]，白细胞[WBC]和纤维蛋白原）伴随虚弱的进展。
方法：2316名参与者（年龄67.9±6.1岁）的数据来自8年随访的英国纵向衰老研究（第4、6和8波）。从52个项目中计算出脆弱指数(FI)。混合效应模型和Cox比例风险(Cox-PH)模型用于分析hsCRP的相关性。WBC和纤维蛋白原伴有衰弱进展。炎性生物标志物的值是对数转化的。年龄,性别和总财富受到控制。
结果：混合效应模型表明，在横截面水平上，hsCRP水平较高（β：0.007，95%CI0.004-0.010），白细胞（β：0.021，95％CI0.010-0.032）和纤维蛋白原（β：0.022，95％CI0.005-0.038）与更高的FI值相关，而没有发现明显的时间相互作用。Cox-PH模型显示，较高的hsCRP（HR：1.10，95％CI1.03-1.17）和WBC（HR：1.23，95％CI1.10-1.37）的基线水平与8年内发生虚弱的风险有关。
结论：我们得出结论，hsCRP，WBC和纤维蛋白原可以反映横断面水平的虚弱状态，而只有hsCRP和WBC与8年的虚弱进展相关。
方法：为了研究三种常见的炎症标志物（超敏C反应蛋白[hsCRP]，白细胞[WBC]和纤维蛋白原）伴随虚弱的进展。
方法：2316名参与者（年龄67.9±6.1岁）的数据来自8年随访的英国纵向衰老研究（第4、6和8波）。从52个项目中计算出脆弱指数(FI)。混合效应模型和Cox比例风险(Cox-PH)模型用于分析hsCRP的相关性。WBC和纤维蛋白原伴有衰弱进展。炎性生物标志物的值是对数转化的。年龄,性别和总财富受到控制。
结果：混合效应模型表明，在横截面水平上，hsCRP水平较高（β：0.007，95%CI0.004-0.010），白细胞（β：0.021，95％CI0.010-0.032）和纤维蛋白原（β：0.022，95％CI0.005-0.038）与更高的FI值相关，而没有发现明显的时间相互作用。Cox-PH模型显示，较高的hsCRP（HR：1.10，95％CI1.03-1.17）和WBC（HR：1.23，95％CI1.10-1.37）的基线水平与8年内发生虚弱的风险有关。
结论：我们得出结论，hsCRP，WBC和纤维蛋白原可以反映横断面水平的虚弱状态，而只有hsCRP和WBC与8年的虚弱进展相关。
