Soluble Tumor Necrosis Factor Receptors and Heart Failure Risk in Older Adults. The Health, Aging, and Body Composition Study 公开

Marti, Catherine Norton (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/j96021281?locale=zh
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Abstract

Background: Tumor necrosis factor (TNF) affects cardiac contractility and remodeling, and TNF levels are associated with risk for heart failure (HF). The soluble TNF type-1 (sTNFR1) and type-2 (sTNFR2) receptors are elevated in patients with manifest HF, but whether they are associated with risk for incident HF is unclear.
Methods: The Health Aging and Body Composition (ABC) Study is a prospective cohort study. Using Cox proportional hazard models, we examined the association between baseline levels of sTNF-R1 and sTNF-R2 and incident HF risk among 1285 participants of the Health ABC cohort (age 74±2.9 years; 51.4% female; 41.1% black).
Results: At baseline, median (interquartile range) TNF, sTNF-R1, and sTNF-R2 levels were 3.14 (2.42-4.06)pg/ml, 1.46 (1.25-1.76)ng/ml, and 3.43 (2.95-4.02)ng/ml, respectively. BothsTNF-R1 and R2 levels modestly correlated with age, black race, and waist/thigh circumference ratio, serum creatinine, triglyceride, and low- and high-density lipoprotein levels. During a median follow-up of 11.4 (interquartile range 6.9, 11.7) years, 233 (18.1%) participants developed HF. In models controlling for the Health ABC HF Risk Model, TNF (hazard ratio [HR], 1.28; 95% confidence interval [CI], 1.02, 1.61 per log2 increase), and sTNF-R1 (HR, 1.68; 95%CI, 1.15, 2.46 per log2 increase), but not sTNF-R2 (HR, 1.15; 95%CI, 0.80, 1.63 per log2 increase), were associated with a higher risk for HF. These associations were consistent across whites and blacks (TNF, sTNF-R1, sTNF-R2, interaction P=0.531, 0.091 and 0.795, respectively), and in both genders (TNF, sTNF-R1, sTNF-R2, interaction p=0.491, 0.672 and 0.999, respectively).
Conclusions: In older adults, elevated levels of sTNF-R1 are associated with an increased risk for incident HF.

Table of Contents

Introduction 1

Background 2

Methods 5

Results 8

Discussion 10

References 13

Tables/Figures 20

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