Inflammatory markers and cardiovascular disease (The Health, Aging and Body Composition [Health ABC] Study)
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Matteo Cesari1, Brenda W J H Penninx, Anne B Newman
1Sticht Center on Aging, Wake Forest University Health Sciences, Winston-Salem, North Carolina 27157, USA. mcesari@wfubmc.edu
Insights
Elevated levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) are linked to increased risks of subclinical and clinical cardiovascular disease in older adults. C-reactive protein (CRP) showed a weaker association overall but was linked to congestive heart failure.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Immunology
- Biomarkers
Background:
- Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality in aging populations.
- Inflammatory processes are increasingly recognized as key contributors to the development of atherosclerosis and CVD.
- Specific inflammatory markers, including cytokines and their soluble receptors, may serve as indicators of CVD risk.
Purpose of the Study:
- To investigate the association between serum levels of key inflammatory markers and subclinical or clinical cardiovascular disease in older adults.
- To compare the predictive value of interleukin-6 (IL-6), C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), and their soluble receptors for CVD.
Main Methods:
- Cross-sectional analysis of 3,045 well-functioning individuals aged 70-79 years from the Health, Aging and Body Composition study.
- Participants categorized into 'cardiovascular disease', 'subclinical cardiovascular disease', or 'no cardiovascular disease' groups.
- Serum levels of IL-6, CRP, TNF-alpha, and soluble cytokine receptors were measured and statistically analyzed for associations.
Main Results:
- Higher levels of IL-6 and TNF-alpha were significantly associated with increased odds of both subclinical and clinical cardiovascular disease.
- C-reactive protein (CRP) showed no significant association with overall subclinical or clinical CVD, but was linked to congestive heart failure.
- Tumor necrosis factor soluble receptor I was the only soluble receptor significantly associated with clinical cardiovascular disease.
Conclusions:
- Interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) play a significant role in both subclinical and clinical cardiovascular disease in older adults.
- CRP demonstrated a weaker association with overall CVD compared to IL-6 and TNF-alpha in this cohort.
- These findings highlight the importance of specific inflammatory cytokines as potential biomarkers for cardiovascular risk assessment in the elderly.
Abstract:
This study investigates the association of several inflammatory markers with subclinical and clinical cardiovascular disease in older men and women. Data are from the baseline assessment of 3,045 well-functioning persons aged 70 to 79 years, participating in the Health, Aging and Body Composition study. The study sample was divided into 3 groups: "cardiovascular disease" (diagnosis of congestive heart failure, coronary artery disease, peripheral artery disease, or stroke), "subclinical cardiovascular disease" (positive findings on the Rose questionnaire for angina or claudication, ankle-brachial index <0.9, or electrocardiographic abnormalities), and "no cardiovascular disease." Serum levels of interleukin (IL)-6, C-reactive protein (CRP), tumor necrosis factor (TNF)-alpha, and the soluble receptors IL-6 soluble receptor, IL-2 soluble receptor, TNF soluble receptor I, and TNF soluble receptor II were assessed. Of those with IL-6 levels in the highest compared with the lowest tertile, the odds ratio (OR) for subclinical cardiovascular disease was 1.58 (95% confidence interval [CI] 1.26 to 1.97) and for clinical cardiovascular disease was 2.35 (95% CI 1.79 to 3.09). A similar association was found for TNF-alpha (OR 1.48, 95% CI 1.16 to 1.88 and OR 2.05, 95% CI 1.55 to 2.72, respectively). In adjusted analyses, CRP was not significantly associated with overall subclinical or clinical cardiovascular disease, although additional analyses did find a strong specific association between CRP and congestive heart failure (OR 1.64, 95% CI 1.11 to 2.41). Of the soluble cytokine receptors, only TNF soluble receptor I showed a significant association with clinical cardiovascular disease. Thus, our findings suggest an important role for IL-6 and TNF-alpha in clinical as well as subclinical cardiovascular disease. In this study, CRP had a weaker association with cardiovascular disease than the cytokines.
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