McKechnie, DGJ; Papacosta, AO; Lennon, LT; Ramsay, SE; Whincup, PH; Wannamethee, SG
(2021)
Associations between inflammation, cardiovascular biomarkers and incident frailty: the British Regional Heart Study.
Age Ageing, 50 (6).
pp. 1979-1987.
ISSN 1468-2834
https://doi.org/10.1093/ageing/afab143
SGUL Authors: Whincup, Peter Hynes
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Abstract
INTRODUCTION: cardiovascular disease (CVD) and chronic inflammation are implicated in the development of frailty. Longitudinal analyses of inflammatory markers, biomarkers of cardiac dysfunction and incidence of frailty are limited. METHODS: in the British Regional Heart Study, 1,225 robust or pre-frail men aged 71-92 years underwent a baseline examination, with questionnaire-based frailty assessment after 3 years. Frailty definitions were based on the Fried phenotype. Associations between incident frailty and biomarkers of cardiac dysfunction (high-sensitivity cardiac troponin T (hs-cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP)) and inflammation (C-reactive protein (CRP) and interleukin-6 (IL-6)) were examined, by tertile, with the lowest as reference. RESULTS: follow-up data were available for 981 men. Ninety one became frail. Adjusted for age, pre-frailty, prevalent and incident CVD, comorbidity, polypharmacy and socioeconomic status, IL-6 (third tertile OR 2.36, 95% CI 1.07-5.17) and hs-cTnT (third tertile OR 2.24, 95% CI 1.03-4.90) were associated with increased odds of frailty. CRP (third tertile OR 1.83, 95% CI 0.97-4.08) and NT-proBNP (second tertile OR 0.48, 95% CI 0.23-1.01) showed no significant association with incident frailty. The top tertiles of CRP, IL-6, hscTnT and NT-proBNP were strongly associated with mortality prior to follow-up. CONCLUSION: IL-6 is associated with incident frailty, supporting the prevailing argument that inflammation is involved in the pathogenesis of frailty. Cardiomyocyte injury may be associated with frailty risk. Associations between elevated CRP and frailty cannot be fully discounted; NT-proBNP may have a non-linear relationship with incident frailty. CRP, IL-6, hs-cTnT and NT-proBNP are vulnerable to survivorship bias.
Item Type: | Article | |||||||||
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Additional Information: | © The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com | |||||||||
Keywords: | aging, biomarkers, frailty, inflammation, older people, pro-brain natriuretic peptide (1–76), troponin T, aging, biomarkers, frailty, inflammation, older people, pro-brain natriuretic peptide (1–76), troponin T, Geriatrics, 1103 Clinical Sciences, 1701 Psychology, 1117 Public Health and Health Services | |||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Population Health Research Institute (INPH) | |||||||||
Journal or Publication Title: | Age Ageing | |||||||||
ISSN: | 1468-2834 | |||||||||
Language: | eng | |||||||||
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Publisher License: | Creative Commons: Attribution-Noncommercial 4.0 | |||||||||
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PubMed ID: | 34254997 | |||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/113480 | |||||||||
Publisher's version: | https://doi.org/10.1093/ageing/afab143 |
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