Association between plasma levels of IL-6 and TNF-α and mild cognitive impairment in the elderly
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摘要:
目的 分析广东老年人(≥65岁)血浆白细胞介素-6(interleukin-6, IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α, TNF-α)水平与轻度认知功能障碍(mild cognitive impairment, MCI)的关联。 方法 选取广东某社区卫生服务中心就诊的48例老年MCI患者作为病例组,96例无MCI的老年人作为对照组。采用logistic回归分析血浆IL-6、TNF-α水平与MCI的关联。绘制受试者工作特征(receiver operating characteristic, ROC)曲线评估血浆IL-6、TNF-α水平对MCI的诊断价值。 结果 共纳入144名老年人,其中48名MCI患者,63名男性(43.8%)。多因素logistic回归分析结果显示,血浆IL-6、TNF-α水平升高可使MCI患病风险增加,血浆IL-6、TNF-α水平每增高1个s,MCI患病风险分别增加53%和51%(OR=1.53, 95% CI: 1.02~2.29, P=0.040; OR=1.51, 95% CI: 1.04~2.20, P=0.029)。血浆IL-6、TNF-α的ROC曲线下面积分别为0.60、0.64。 结论 血浆IL-6和TNF-α水平升高可能与≥65岁老年人MCI患病风险的增加有关。 Abstract:Objective To analyze the association between plasma levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and mild cognitive impairment (MCI) in elderly individuals aged 65 years and older in Guangdong. Methods A total of 48 MCI elderly patients who visited a community health service center in Guangdong were selected as the case group, while 96 non-MCI individuals served as controls. Logistic regression models were used to analyze the association between plasma levels of IL-6 and TNF-α and MCI. Receiver operating characteristic (ROC) curves were plotted to evaluate the diagnostic value of plasma levels of IL-6 and TNF-α for MCI. Results A total of 144 elderly individuals were enrolled, including 48 MCI patients and 63 males (43.8%). The results of the multivariate logistic regression models showed that increased plasma levels of IL-6 and TNF-α could lead to a higher risk of MCI. Specifically, the risk of MCI increased by 53% and 51% for each standard deviation increase in plasma levels of IL-6 and TNF-α, respectively (OR=1.53, 95% CI: 1.02-2.29, P=0.040; OR=1.51, 95% CI: 1.04-2.20, P=0.029). The areas under the ROC curves for IL-6 and TNF-α were 0.60 and 0.64, respectively. Conclusions The increased risk of MCI in individuals aged 65 years and older may be associated with elevated plasma levels of IL-6 and TNF-α. -
Key words:
- Elderly /
- Mild cognitive impairment /
- Interleukin-6 /
- Tumor necrosis factor-α /
- Case-control study
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表 1 研究对象基本特征
Table 1. Basic characteristics of the study subjects
变量Variable 总人数 ①Total ①(n=144) 对照组 ①Control group ①(n=96) MCI组 ①group ①(n=48) χ2/Z值value P值value 年龄/岁Age/years 72.0(69.0, 80.0) 72.5(69.0, 80.8) 71.5(69.0, 80.0) -0.117 0.907 性别Gender 0.001 0.999 男Male 63(43.8) 42(43.8) 21(43.8) 女Female 81(56.2) 54(56.2) 27(56.2) 婚姻状况Marital status 0.077 0.781 在婚Married 110(76.4) 74(77.1) 36(75.0) 其他Other 34(23.6) 22(22.9) 12(25.0) 吸烟Smoking 0.054 0.817 否No 134(93.1) 89(92.7) 45(93.8) 是Yes 10(6.9) 7(7.3) 3(6.2) 饮酒Drinking 0.030 0.862 否No 125(86.8) 83(86.5) 42(87.5) 是Yes 19(13.2) 13(13.5) 6(12.5) 锻炼情况Exercise status 0.286 0.593 是Yes 126(87.5) 85(88.5) 41(85.4) 否No 18(12.5) 11(11.5) 7(14.6) 高血压Hypertension 0.694 0.405 否No 62(43.1) 39(40.6) 23(47.9) 是Yes 82(56.9) 57(59.4) 25(52.1) 糖尿病Diabetes 0.758 0.384 否No 114(79.2) 74(77.1) 40(83.3) 是Yes 30(20.8) 22(22.9) 8(16.7) 冠状动脉粥样硬化Coronary heart disease 2.133 0.144 否No 135(93.8) 88(91.7) 47(97.9) 是Yes 9(6.2) 8(8.3) 1(2.1) 脑血管病Cerebrovascular disease 0.414 0.520 否No 139(96.5) 92(95.8) 47(97.9) 是Yes 5(3.5) 4(4.2) 1(2.1) 关节炎Arthritis 2.532 0.112 否No 130(90.3) 84(87.5) 46(95.8) 是Yes 14(9.7) 12(12.5) 2(4.2) IL-6/(ng·L-1) 13.87(11.05, 17.92) 13.41(9.80, 17.67) 14.93(11.96, 19.89) -1.973 0.049 TNF-α/(ng·L-1) 302.78(195.19, 393.37) 265.42(190.71, 374.09) 375.80(236.85, 432.99) -2.712 0.007 注:①以人数(占比/%)或M(P25,P75)表示。
Note: ① Number of people (proportion/%) or M(P25,P75).表 2 血浆IL-6、TNF-α水平与MCI的关联
Table 2. Association between IL-6, TNF-α and MCI
变量Variable 人数Number of people 模型1 Model 1 模型2 Model 2 模型3 Model 3 OR值value(95% CI) P值value OR值value(95% CI) P值value OR值value(95% CI) P值value IL-6/(ng·L-1) 144 1.43(0.99~2.07) 0.054 1.50(1.02~2.18) 0.039 1.53(1.02~2.29) 0.040 <11.10 36 1.00 1.00 1.00 11.10~<13.90 36 3.24(1.07~9.83) 0.038 3.22(1.04~9.97) 0.042 3.53(1.11~11.21) 0.032 13.90~<17.90 36 3.30(1.07~10.14) 0.037 3.51(1.09~11.34) 0.036 3.37(1.02~11.17) 0.047 ≥17.90 36 3.24(1.07~9.83) 0.038 3.54(1.13~11.03) 0.030 4.14(1.28~13.40) 0.018 Ptrend 0.059 0.045 0.032 TNF-α/(ng·L-1) 144 1.43(1.01~2.04) 0.047 1.51(1.05~2.17) 0.025 1.51(1.04~2.20) 0.029 <194.20 36 1.00 1.00 1.00 194.20~<297.20 36 0.72(0.23~2.22) 0.566 0.75(0.24~2.36) 0.627 0.68(0.21~2.18) 0.519 297.20~<391.88 36 2.13(0.77~5.91) 0.145 2.45(0.85~7.03) 0.096 2.26(0.76~6.70) 0.142 ≥391.88 36 2.67(0.98~7.28) 0.055 2.99(1.07~8.34) 0.037 3.13(1.09~8.97) 0.034 Ptrend 0.013 0.008 0.008 注:模型1,调整年龄、性别;模型2,在模型1的基础上进一步调整婚姻状况、吸烟、饮酒、锻炼;模型3,在模型2的基础上进一步调整高血压、糖尿病、冠状动脉粥样硬化、脑血管病及关节炎患病情况。
Notes: Model 1, adjusting for age, gender; Model 2, on the basis of model 1, marital status, smoking, drinking, exercise were adjusted; Model 3, on the basis of model 2, hypertension, diabetes, coronary heart disease, cerebrovascular disease, arthritis were adjusted.表 3 血浆IL-6、TNF-α水平对MCI的诊断价值
Table 3. Diagnostic value of plasma levels of IL-6 and TNF-α for MCI
变量Variable AUC 95% CI P值value 诊断临界值/(ng·L-1)Cut-off point/(ng·L-1) 约登指数Youden index 灵敏度/%Sensitivity/% 特异度/%Specificity/% IL-6/(ng·L-1) 0.60 0.51~0.69 0.049 11.31 0.24 87.50 36.50 TNF-α/(ng·L-1) 0.64 0.54~0.74 0.007 353.86 0.32 62.50 69.80 -
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