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

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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About this Master's Thesis

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School	Laney Graduate School
Department	Clinical Research Curriculum Program
Degree	MS
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Medicine and Surgery
关键词	outcomes tumor necrosis factor heart failure
Committee Chair / Thesis Advisor	Butler, Javed, Emory University
Committee Members	Esper, Annette , Emory University Klein, Mitchel, Emory University

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