Associations Between Inflammation and Physical Function in African Americans and European Americans with Prevalent Cardiovascular Risk Factors

B. Gwen Windham, Steven R. Wilkening, Seth T. Lirette, Iftikhar Jan Kullo, Stephen T Turner, Michael E. Griswold, Thomas H. Mosley

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objectives: To examine associations between inflammation and physical function and potential mediation by white matter hyperintensities (WMHs) in African Americans (AAs) and European Americans (EAs). Design: Cross-sectional analysis using linear and logistic models with generalized estimating equations to account for family clustering, reporting results as regression coefficients (β) and odds ratios (ORs) adjusted for education, alcohol, exercise, body mass index, hypertension, diabetes mellitus, heart disease, cognition, ankle–brachial index, race (site), and supported interactions. Setting: Genetic Epidemiology Network of Arteriopathy-Genetics of Microangiopathic Brain Injury Study cohort. Participants: AA and EA sibships with two or more siblings with hypertension before age 60 (N = 1,960; 65% female, 51% AA, aged 26–91, 50% obese, 72% hypertensive). Measurements: Inflammation (C-reactive protein (CRP), interleukin-6 (IL6), soluble tumor necrosis factor receptors (sTNFRs) 1 and 2, WMH volume (cm3) according to magnetic resonance imaging), walking speed (cm/s) over 25 feet, and mobility difficulty (any self-reported difficulty walking half a mile). Results: In separate models, inflammatory markers were associated with walking speed (sTNFR1: β = −2.74, P <.001; sTNFR2: β = −1.23, P =.03; CRP: β = −1.95, P =.001; IL6: β = −1.24, P =.03) and mobility difficulty (sTNFR1: OR = 1.36, P =.001; sTNFR2: OR = 1.25, P =.005; CRP: OR = 1.22, P =.005; IL6: OR = 1.18, P =.02); the association between WMH volume and sTNFR1 in AA (β = 0.07, P =.06) did not reach typical statistical thresholds. WMH volume was associated with walking speed in AA (β = −3.17, P =.02) but not with mobility difficulty (OR = 1.10, P =.54). Adjusting for WMH did not change associations. Conclusion: In young, middle-aged, and older adults with prevalent cardiovascular risk factors, multiple inflammatory biomarkers were associated with slower walking speed independent of microvascular disease in the brain. There was little evidence of mediation by brain WMH volume. Inflammation may contribute to physical function impairments through pathways other than brain microvascular disease, particularly in AAs.

Original languageEnglish (US)
Pages (from-to)1448-1455
Number of pages8
JournalJournal of the American Geriatrics Society
Volume64
Issue number7
DOIs
StatePublished - Jul 1 2016

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African Americans
Odds Ratio
Inflammation
C-Reactive Protein
Interleukin-6
Brain Diseases
Receptors, Tumor Necrosis Factor, Type II
Mobility Limitation
Hypertension
Molecular Epidemiology
Brain Injuries
Cognition
Cluster Analysis
White Matter
Siblings
Linear Models
Heart Diseases
Diabetes Mellitus
Body Mass Index
Cohort Studies

Keywords

  • ethnicity
  • inflammation
  • physical function
  • white matter hyperintensity

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Associations Between Inflammation and Physical Function in African Americans and European Americans with Prevalent Cardiovascular Risk Factors. / Windham, B. Gwen; Wilkening, Steven R.; Lirette, Seth T.; Kullo, Iftikhar Jan; Turner, Stephen T; Griswold, Michael E.; Mosley, Thomas H.

In: Journal of the American Geriatrics Society, Vol. 64, No. 7, 01.07.2016, p. 1448-1455.

Research output: Contribution to journalArticle

@article{0e27bc1178f04582b4f45e27d1540827,
title = "Associations Between Inflammation and Physical Function in African Americans and European Americans with Prevalent Cardiovascular Risk Factors",
abstract = "Objectives: To examine associations between inflammation and physical function and potential mediation by white matter hyperintensities (WMHs) in African Americans (AAs) and European Americans (EAs). Design: Cross-sectional analysis using linear and logistic models with generalized estimating equations to account for family clustering, reporting results as regression coefficients (β) and odds ratios (ORs) adjusted for education, alcohol, exercise, body mass index, hypertension, diabetes mellitus, heart disease, cognition, ankle–brachial index, race (site), and supported interactions. Setting: Genetic Epidemiology Network of Arteriopathy-Genetics of Microangiopathic Brain Injury Study cohort. Participants: AA and EA sibships with two or more siblings with hypertension before age 60 (N = 1,960; 65{\%} female, 51{\%} AA, aged 26–91, 50{\%} obese, 72{\%} hypertensive). Measurements: Inflammation (C-reactive protein (CRP), interleukin-6 (IL6), soluble tumor necrosis factor receptors (sTNFRs) 1 and 2, WMH volume (cm3) according to magnetic resonance imaging), walking speed (cm/s) over 25 feet, and mobility difficulty (any self-reported difficulty walking half a mile). Results: In separate models, inflammatory markers were associated with walking speed (sTNFR1: β = −2.74, P <.001; sTNFR2: β = −1.23, P =.03; CRP: β = −1.95, P =.001; IL6: β = −1.24, P =.03) and mobility difficulty (sTNFR1: OR = 1.36, P =.001; sTNFR2: OR = 1.25, P =.005; CRP: OR = 1.22, P =.005; IL6: OR = 1.18, P =.02); the association between WMH volume and sTNFR1 in AA (β = 0.07, P =.06) did not reach typical statistical thresholds. WMH volume was associated with walking speed in AA (β = −3.17, P =.02) but not with mobility difficulty (OR = 1.10, P =.54). Adjusting for WMH did not change associations. Conclusion: In young, middle-aged, and older adults with prevalent cardiovascular risk factors, multiple inflammatory biomarkers were associated with slower walking speed independent of microvascular disease in the brain. There was little evidence of mediation by brain WMH volume. Inflammation may contribute to physical function impairments through pathways other than brain microvascular disease, particularly in AAs.",
keywords = "ethnicity, inflammation, physical function, white matter hyperintensity",
author = "Windham, {B. Gwen} and Wilkening, {Steven R.} and Lirette, {Seth T.} and Kullo, {Iftikhar Jan} and Turner, {Stephen T} and Griswold, {Michael E.} and Mosley, {Thomas H.}",
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T1 - Associations Between Inflammation and Physical Function in African Americans and European Americans with Prevalent Cardiovascular Risk Factors

AU - Windham, B. Gwen

AU - Wilkening, Steven R.

AU - Lirette, Seth T.

AU - Kullo, Iftikhar Jan

AU - Turner, Stephen T

AU - Griswold, Michael E.

AU - Mosley, Thomas H.

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N2 - Objectives: To examine associations between inflammation and physical function and potential mediation by white matter hyperintensities (WMHs) in African Americans (AAs) and European Americans (EAs). Design: Cross-sectional analysis using linear and logistic models with generalized estimating equations to account for family clustering, reporting results as regression coefficients (β) and odds ratios (ORs) adjusted for education, alcohol, exercise, body mass index, hypertension, diabetes mellitus, heart disease, cognition, ankle–brachial index, race (site), and supported interactions. Setting: Genetic Epidemiology Network of Arteriopathy-Genetics of Microangiopathic Brain Injury Study cohort. Participants: AA and EA sibships with two or more siblings with hypertension before age 60 (N = 1,960; 65% female, 51% AA, aged 26–91, 50% obese, 72% hypertensive). Measurements: Inflammation (C-reactive protein (CRP), interleukin-6 (IL6), soluble tumor necrosis factor receptors (sTNFRs) 1 and 2, WMH volume (cm3) according to magnetic resonance imaging), walking speed (cm/s) over 25 feet, and mobility difficulty (any self-reported difficulty walking half a mile). Results: In separate models, inflammatory markers were associated with walking speed (sTNFR1: β = −2.74, P <.001; sTNFR2: β = −1.23, P =.03; CRP: β = −1.95, P =.001; IL6: β = −1.24, P =.03) and mobility difficulty (sTNFR1: OR = 1.36, P =.001; sTNFR2: OR = 1.25, P =.005; CRP: OR = 1.22, P =.005; IL6: OR = 1.18, P =.02); the association between WMH volume and sTNFR1 in AA (β = 0.07, P =.06) did not reach typical statistical thresholds. WMH volume was associated with walking speed in AA (β = −3.17, P =.02) but not with mobility difficulty (OR = 1.10, P =.54). Adjusting for WMH did not change associations. Conclusion: In young, middle-aged, and older adults with prevalent cardiovascular risk factors, multiple inflammatory biomarkers were associated with slower walking speed independent of microvascular disease in the brain. There was little evidence of mediation by brain WMH volume. Inflammation may contribute to physical function impairments through pathways other than brain microvascular disease, particularly in AAs.

AB - Objectives: To examine associations between inflammation and physical function and potential mediation by white matter hyperintensities (WMHs) in African Americans (AAs) and European Americans (EAs). Design: Cross-sectional analysis using linear and logistic models with generalized estimating equations to account for family clustering, reporting results as regression coefficients (β) and odds ratios (ORs) adjusted for education, alcohol, exercise, body mass index, hypertension, diabetes mellitus, heart disease, cognition, ankle–brachial index, race (site), and supported interactions. Setting: Genetic Epidemiology Network of Arteriopathy-Genetics of Microangiopathic Brain Injury Study cohort. Participants: AA and EA sibships with two or more siblings with hypertension before age 60 (N = 1,960; 65% female, 51% AA, aged 26–91, 50% obese, 72% hypertensive). Measurements: Inflammation (C-reactive protein (CRP), interleukin-6 (IL6), soluble tumor necrosis factor receptors (sTNFRs) 1 and 2, WMH volume (cm3) according to magnetic resonance imaging), walking speed (cm/s) over 25 feet, and mobility difficulty (any self-reported difficulty walking half a mile). Results: In separate models, inflammatory markers were associated with walking speed (sTNFR1: β = −2.74, P <.001; sTNFR2: β = −1.23, P =.03; CRP: β = −1.95, P =.001; IL6: β = −1.24, P =.03) and mobility difficulty (sTNFR1: OR = 1.36, P =.001; sTNFR2: OR = 1.25, P =.005; CRP: OR = 1.22, P =.005; IL6: OR = 1.18, P =.02); the association between WMH volume and sTNFR1 in AA (β = 0.07, P =.06) did not reach typical statistical thresholds. WMH volume was associated with walking speed in AA (β = −3.17, P =.02) but not with mobility difficulty (OR = 1.10, P =.54). Adjusting for WMH did not change associations. Conclusion: In young, middle-aged, and older adults with prevalent cardiovascular risk factors, multiple inflammatory biomarkers were associated with slower walking speed independent of microvascular disease in the brain. There was little evidence of mediation by brain WMH volume. Inflammation may contribute to physical function impairments through pathways other than brain microvascular disease, particularly in AAs.

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