TY - JOUR
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 J.
AU - Turner, Stephen T.
AU - Griswold, Michael E.
AU - Mosley, Thomas H.
N1 - Publisher Copyright:
© 2016, The American Geriatrics Society
PY - 2016/7/1
Y1 - 2016/7/1
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.
KW - ethnicity
KW - inflammation
KW - physical function
KW - white matter hyperintensity
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U2 - 10.1111/jgs.14229
DO - 10.1111/jgs.14229
M3 - Article
C2 - 27310030
AN - SCOPUS:84978424140
SN - 0002-8614
VL - 64
SP - 1448
EP - 1455
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
IS - 7
ER -