Inflammatory markers and occurrence of falls: Bambuí Cohort Study of Aging

ABSTRACT OBJECTIVE Analyze whether inflammatory markers are associated with falls among older adults living in Bambuí. METHODS Study that analyzed baseline data from a Bambuí Cohort Study of Aging, involving 1,250 participants. Data about falls were collected from previous 12 months, classified as single or multiple occurrence and severity (participant seeking health services). Information about sociodemographic characteristics, health behaviors and health condition was also collected and used as confounding factors. The exposures of interest included interleukins (IL-1β, IL-6, IL-8, IL-10, IL-12), tumor necrosis factor (TNF), ultra-sensitive C-reactive protein (us-CRP) and chemokines (CXCL9, CCL5, CCL10, MCP1). Data were processed through logistic regression, obtaining odds ratio and 95% confidence interval (95%CI). RESULTS The prevalence of falls was 27.1%; 40.1% of the older adults reported multiple falls and 33.3% sought health services. After adjustments, the following elevated levels were associated with falls: us-CRP (OR = 1.46, 95%CI 1.04–2.03), CCL5 (OR = 1.38, 95%CI 1.01–1.90) and CXCL9 (OR = 1.43, 95%CI 1.02–2.02). An association was observed between the number of elevated markers and the occurrence of falls: two (OR = 1.47, 95%CI 1.02–2.12) and three (OR = 2.08, 95%CI 1.12–3.87) elevated biomarkers indicated fall probability of 32.0% and 39.4%, respectively. CONCLUSIONS Elevated levels of us-CRP, CCL5 and CXCL9, which were associated with falls, may contribute to a proper understanding of the mechanism associated with the occurrence of falls among older people.摘要 目的：分析居住在Bambuí的老年人群中炎症标志物与跌倒事件的相关性。 方法：本研究分析Bambuí老年队列研究（Bambuí Cohort Study of Aging）的基线数据，共纳入1250名参与者。跌倒相关数据收集自受试者过去12个月的情况，按跌倒次数（单次或多次）及严重程度（是否就医）进行分类。同时收集社会人口学特征、健康行为与健康状况等信息作为混杂调整因素。本研究关注的暴露指标包括白细胞介素类（IL-1β、IL-6、IL-8、IL-10、IL-12）、肿瘤坏死因子（TNF）、超敏C反应蛋白（ultra-sensitive C-reactive protein, us-CRP）以及趋化因子类（CXCL9、CCL5、CCL10、MCP1）。采用logistic回归模型处理数据，计算比值比（odds ratio, OR）及95%置信区间（95% confidence interval, 95%CI）。 结果：本研究人群跌倒患病率为27.1%；其中40.1%的老年人报告存在多次跌倒，33.3%的受试者因跌倒寻求医疗服务。经混杂因素校正后，以下指标水平升高与跌倒发生显著相关：超敏C反应蛋白（us-CRP，OR=1.46，95%CI 1.04~2.03）、CCL5（OR=1.38，95%CI 1.01~1.90）以及CXCL9（OR=1.43，95%CI 1.02~2.02）。此外，升高的炎症标志物数量与跌倒发生风险呈正相关：携带2种升高的生物标志物时，跌倒比值比为1.47（95%CI 1.02~2.12），跌倒概率为32.0%；携带3种升高的生物标志物时，比值比为2.08（95%CI 1.12~3.87），跌倒概率为39.4%。 结论：与跌倒相关的超敏C反应蛋白、CCL5及CXCL9水平升高，或可为深入阐明老年人群跌倒发生的潜在机制提供科学参考。