Interleukin-6 as a first-rated serum inflammatory marker to predict mortality and hospitalization in the oldest old: A regression and CART approach in the BELFRAIL study

被引:42
作者
Adriaensen, Wim [1 ,2 ]
Mathei, Catharina [1 ]
Vaes, Bert [1 ,2 ]
van Pottelbergh, Gijs [1 ]
Wallemacq, Pierre [3 ]
Degryse, Jean-Marie [1 ,2 ]
机构
[1] Katholieke Univ Leuven, Ctr Gen Practice, Dept Publ Hlth & Primary Care, B-3000 Leuven, Belgium
[2] Catholic Univ Louvain, Inst Hlth & Soc, B-1200 Brussels, Belgium
[3] Catholic Univ Louvain, Lab Analyt Biochem, Clin Univ St Luc, B-1200 Brussels, Belgium
关键词
Oldest old; Inflammaging; Mortality; Hospitalization; IL-6; C-REACTIVE PROTEIN; CORONARY-HEART-DISEASE; ALL-CAUSE MORTALITY; CARDIOVASCULAR-DISEASE; SYSTEMIC INFLAMMATION; MYOCARDIAL-INFARCTION; FUNCTIONAL DECLINE; HEALTH; RISK; MULTIMORBIDITY;
D O I
10.1016/j.exger.2015.06.005
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background: Certain inflammatory biomarkers increase with age, provide information about general burden of illness and could cause or reflect any collateral damage to healthy cells and organs. However, comparative studies to predict adverse outcomes are missing. Therefore, our study validated and identified the principal prognostic marker to predict important adverse outcomes in the oldest old from an extensive battery of serum inflammatory markers. Methods: A large battery of potential 'inflammaging' markers (IL-1 alpha, IL1-beta, IL-4, IL-6, IL-8, IL-10, TNF-alpha, IFN-gamma, EGF, VEGF, MCP-1, usCRP, prealbumin) was assessed in a representative sample of 415 heterogenic individuals 80 years of age or older in the BELFRAIL study. Kaplan-Meier, Cox proportional hazards and CART analyses determined the overall prognostic value of these markers for predicting all-cause, cardiovascular and non-cardiovascular mortality as well as hospitalization. Results: Serum IL-6 and usCRP levels were strongly associated with time of survival, independent of cause of death. Serum IL-6 levels had the most robust dose-response relationship with mortality. To a lesser extent, IL-10 and IL-1 beta were associated with all-cause mortality but were restricted to non-cardiovascular or cardiovascular mortality, respectively. Having a low IL-6 at baseline (<1.77 pg/ml) could predict 90% of those who were not at risk for all-cause mortality after 3 years, even after adjusting for confounders. Similarly, we observed an 83.6% chance of identifying those cases with 0 or 1 hospitalization using low IL-6 serum levels. Conclusion: The results suggest that a single measurement of low IL-6 serum levels is the first choice to guide clinical practice in the oldest old and could summarize the short-term risk of death and hospitalization. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:53 / 61
页数:9
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