Non-EsterifiedFatty Acids and Risks of Frailty, Disability, and Mobility Limitation in Older Adults: The Cardiovascular Health Study

被引:7
|
作者
Ahiawodzi, Peter [1 ]
Djousse, Luc [2 ,3 ]
Ix, Joachim H. [4 ,5 ]
Kizer, Jorge R. [6 ]
Tracy, Russell P. [7 ]
Arnold, Alice [8 ]
Newman, Anne [9 ,10 ]
Mukamal, Kenneth J. [3 ,11 ]
机构
[1] Campbell Univ, Coll Pharm & Hlth Sci, Dept Publ Hlth, Buies Creek, NC 27506 USA
[2] Brigham & Womens Hosp, Dept Med, Div Aging, 75 Francis St, Boston, MA 02115 USA
[3] Harvard Med Sch, Boston, MA 02115 USA
[4] Univ Calif San Diego, Div Nephrol, San Diego, CA 92103 USA
[5] Univ Calif San Diego, Div Prevent Med, San Diego, CA 92103 USA
[6] Univ Calif San Francisco, Div Cardiol, Vet Affairs Med Ctr, San Francisco, CA USA
[7] Univ Vermont, Coll Med, Dept Pathol & Biochem, Burlington, VT USA
[8] Univ Washington, Dept Biostat, Seattle, WA 98195 USA
[9] Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15261 USA
[10] Univ Pittsburgh, Dept Med, Pittsburgh, PA USA
[11] Beth Israel Deaconess Med Ctr, Div Gen Med, Boston, MA 02215 USA
关键词
non-esterified fatty acids; frailty; disability; mobility limitation; FREE FATTY-ACIDS; SKELETAL-MUSCLE; OXIDATIVE STRESS; MITOCHONDRIAL DYSFUNCTION; ADIPOSE-TISSUE; GLUCOSE-UPTAKE; INSULIN; RESISTANCE; APOPTOSIS; LIPOLYSIS;
D O I
10.1111/jgs.16793
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/OBJECTIVES Non-esterified fatty acids (NEFAs) play central roles in the relationship between adiposity and glucose metabolism, and they have been implicated in the pathogenesis of cardiovascular disease, but few studies have assessed their effects on complex geriatric syndromes like frailty that cross multiple organ systems. We sought to determine the relationships between NEFAs and incident frailty, disability, and mobility limitation in a population-based cohort of older persons. METHODS We analyzed 4,710 Cardiovascular Health Study (CHS) participants who underwent measurement of circulating total fasting NEFAs in 1992-1993 and were assessed for frailty in 1996-1997 and for disability and mobility limitation annually. We used ordinal logistic regression to model incident frailty, linear regression to model components of frailty, and Cox regression to model disability and mobility limitation in relation to baseline NEFAs. To ensure proportional hazards, we truncated follow-up at 9 years for disability and 6.5 years for mobility limitation. RESULTS A total of 42 participants became frail and 510 became pre-frail over a 4-year period, and we documented 1,720 cases of disability and 1,225 cases of mobility limitation during follow-up. NEFAs were positively associated in a dose-dependent manner with higher risks of incident frailty, disability, and mobility limitation. The adjusted odds ratios for frailty were 1.37 (95% confidence interval [CI] = 1.01-1.86; P = .04) across extreme tertiles and 1.17 (95% CI = 1.03-1.33; P = .01) per standard deviation increment. The corresponding hazard ratios for incident disability were 1.14 (95% CI = 1.01-1.30; P = .04) and 1.11 (95% CI = 1.06-1.17; P < .0001); those for incident mobility limitation were 1.23 (95% CI = 1.06-1.43; P = .006) and 1.15 (95% CI = 1.08-1.22; P < .0001). Results were largely consistent among both men and women. Among individual components of frailty, NEFAs were significantly associated with self-reported exhaustion (beta = .07; standard error = .03; P = .02). CONCLUSION Circulating NEFAs are significantly associated with frailty, disability, and mobility limitation among older adults. These results highlight the broad spectrum of adverse health issues associated with NEFA in older adults.
引用
收藏
页码:2890 / 2897
页数:8
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