Abstract
Background
Aging is associated with increased production of catabolic cytokines, reduced circulating
levels of insulin-like growth factor 1 (IGF-1), and acceleration of sarcopenia (loss
of muscle with age). We hypothesized that these factors are independently linked to
mortality in community-dwelling older persons.
Methods
We examined the relation of all-cause mortality to peripheral blood mononuclear cell
production of inflammatory cytokines (tumor necrosis factor α [TNF-α], interleukin
1β, interleukin 6), serum interleukin 6 and IGF-1, and fat-free mass and clinical
status in 525 ambulatory, free-living participants in the Framingham Heart Study.
Results
Of the 525 subjects (aged 72 to 92 years at baseline), 122 (23%) died during 4 years
of follow-up. After adjusting for age, sex, comorbid conditions, smoking, and body
mass index, mortality was associated with greater cellular production of TNF-α (hazard
ratio [HR] = 1.27 per log10 difference in ng/mL; 95% confidence interval [CI]: 1.00 to 1.61; P = 0.05) and higher serum interleukin 6 levels (HR = 1.30 per log10 difference in pg/mL; 95% CI: 1.04 to 1.63]; P = 0.02), but not with higher serum IGF-1 levels (HR = 0.70 per log10 difference in pg/mL; 95% CI: 0.49 to 0.99; P = 0.04). In a subset of 398 subjects (55 deaths) in whom change in fat-free mass
index during the first 2 years was measured, less loss of fat-free mass and greater
IGF-1 levels were associated with reduced mortality during the next 2 years.
Conclusion
Greater levels or production of the catabolic cytokines TNF-α and interleukin 6 are
associated with increased mortality in community-dwelling elderly adults, whereas
IGF-1 levels had the opposite effect.
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Article Info
Publication History
Accepted:
May 21,
2003
Received:
October 11,
2002
Footnotes
☆Supported by NIH/USDA Interagency Agreement AG-4-0245 (RR); NIH grants DK02120 (RR), AG15797 (RR), and AI-15614 (CAD); NHLBI Contract N01-HC-38038; and USDA Cooperative Agreement 58-1950-9-001. The content of this publication does not necessarily reflect the views or policies of the United States Department of Agriculture or Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. government.
Identification
Copyright
© 2003 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
