1. Inflammation and Thrombosis Biomarkers and Incident Frailty in Postmenopausal Women
- Author
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Reiner, Alexander P, Aragaki, Aaron K, Gray, Shelly L, Wactawski-Wende, Jean, Cauley, Jane A, Cochrane, Barbara B, Kooperberg, Charles L, Woods, Nancy F, and LaCroix, Andrea Z
- Subjects
Reproductive Medicine ,Biomedical and Clinical Sciences ,Clinical Research ,Aging ,Hematology ,Aetiology ,2.1 Biological and endogenous factors ,Aged ,Biomarkers ,C-Reactive Protein ,Case-Control Studies ,Confidence Intervals ,Factor VIII ,Female ,Fibrin Fibrinogen Degradation Products ,Follow-Up Studies ,Frail Elderly ,Humans ,Incidence ,Inflammation ,Multivariate Analysis ,Postmenopause ,Probability ,Prospective Studies ,Risk Assessment ,Thrombosis ,Tissue Plasminogen Activator ,Women's Health ,Medical and Health Sciences ,General & Internal Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundThe immune and blood coagulation systems have been implicated in the pathophysiology of the geriatric syndrome of frailty, but limited prospective data examining the relationship of clotting/inflammation biomarkers to risk of incident frailty exist.MethodsThis prospective analysis was derived from a nested case-control study within the Women's Health Initiative. Among women 65 to 79 years free of frailty at enrollment, we randomly selected 900 incident cases from those developing frailty within 3 years; 900 non-frail controls were individually matched on age, ethnicity, and blood collection date. Biomarkers assessed for risk of incident frailty included fibrinogen, factor VIII, D-dimer, C-reactive protein, interleukin-6, and tissue plasminogen activator (t-PA).ResultsWhen examined by quartiles in multivariable adjusted models, higher D-dimer and t-PA levels were each associated with increased risk of frailty (P trend = .04). Relative to the lowest quartile, the odds ratios for frailty compared with the upper quartile were 1.52 (95% confidence interval, 1.05-2.22) for t-PA and 1.57 (95% confidence interval, 1.11-2.22) for D-dimer. For women having high t-PA and high D-dimer compared with women having lower levels of both biomarkers, the odds of frailty was 2.20 (1.29-3.75). There was little evidence for association between coagulation factor VIII, fibrinogen, C-reactive protein, or interleukin-6 levels and incident frailty.ConclusionThis prospective analysis supports the role of markers of fibrin turnover and fibrinolysis as independent predictors of incident frailty in postmenopausal women.
- Published
- 2009