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Longitudinal changes in adiponectin and inflammatory markers and relation to survival in the oldest old: the Cardiovascular Health Study All Stars study.

TitleLongitudinal changes in adiponectin and inflammatory markers and relation to survival in the oldest old: the Cardiovascular Health Study All Stars study.
Publication TypeJournal Article
Year of Publication2011
AuthorsKizer, JR, Arnold, AM, Jenny, NS, Cushman, M, Strotmeyer, ES, Ives, DG, Ding, J, Kritchevsky, SB, Chaves, PHM, Hirsch, CH, Newman, AB
JournalJ Gerontol A Biol Sci Med Sci
Volume66
Issue10
Pagination1100-7
Date Published2011 Oct
ISSN1758-535X
KeywordsAdiponectin, Aged, 80 and over, Biomarkers, C-Reactive Protein, Cardiovascular Diseases, Chi-Square Distribution, Enzyme-Linked Immunosorbent Assay, Female, Humans, Inflammation, Interleukin-6, Male, Mortality, Predictive Value of Tests, Risk Factors, Sensitivity and Specificity, Survival Analysis, United States
Abstract<p><b>BACKGROUND: </b>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.</p><p><b>METHODS: </b>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).</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSION: </b>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.</p>
DOI10.1093/gerona/glr098
Alternate JournalJ. Gerontol. A Biol. Sci. Med. Sci.
PubMed ID21659339
PubMed Central IDPMC3172562
Grant ListP30 AG024827 / AG / NIA NIH HHS / United States
R01 AG-15928 / AG / NIA NIH HHS / United States
UL1 TR000005 / TR / NCATS NIH HHS / United States
N01-HC-85085 / HC / NHLBI NIH HHS / United States
N01-HC-85081 / HC / NHLBI NIH HHS / United States
R01 HL-075366 / HL / NHLBI NIH HHS / United States
N01-HC-850784 / HC / NHLBI NIH HHS / United States
R01 HL-094555 / HL / NHLBI NIH HHS / United States
P30-AG-024827 / AG / NIA NIH HHS / United States
N01-HC-85086 / HC / NHLBI NIH HHS / United States
K23 HL-070854 / HL / NHLBI NIH HHS / United States
AG-027058 / AG / NIA NIH HHS / United States
N01-HC-85082 / HC / NHLBI NIH HHS / United States
N01-HC-35129 / HC / NHLBI NIH HHS / United States
N01 HC-55222 / HC / NHLBI NIH HHS / United States
N01-HC-85083 / HC / NHLBI NIH HHS / United States
N01-HC-85080 / HC / NHLBI NIH HHS / United States
N01 HC-15103 / HC / NHLBI NIH HHS / United States
R01 AG-20098 / AG / NIA NIH HHS / United States
N01-HC-85079 / HC / NHLBI NIH HHS / United States
AG-023629 / AG / NIA NIH HHS / United States