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首页> 外文期刊>The journals of gerontology.Series A. Biological sciences and medical sciences >Nonlinear multisystem physiological dysregulation associated with frailty in older women: implications for etiology and treatment.
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Nonlinear multisystem physiological dysregulation associated with frailty in older women: implications for etiology and treatment.

机译：与年老体弱者相关的非线性多系统生理失调：对病因和治疗的影响。

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BACKGROUND: Frailty in older adults, defined as a constellation of signs and symptoms, is associated with abnormal levels in individual physiological systems. We tested the hypothesis that it is the critical mass of physiological systems abnormal that is associated with frailty, over and above the status of each individual system, and that the relationship is nonlinear. METHODS: Using data on women aged 70-79 years from the Women's Health and Aging Studies I and II, multiple analytic approaches assessed the cross-sectional association of frailty with eight physiological measures. RESULTS: Abnormality in each system (anemia, inflammation, insulin-like growth factor-1, dehydroepiandrosterone-sulfate, hemoglobin A1c, micronutrients, adiposity, and fine motor speed) was significantly associated with frailty status. However, adjusting for the level of each system measure, the mean number of systems impaired significantly and nonlinearly predicted frailty. Those with three or more systems impaired were most likely to be frail, with odds of frailty increasing with number of systems at abnormal level, from odds ratios (ORs) of 4.8 to 11 to 26 for those with one to two, three to four, and five or more systems abnormal (p < .05 for all). Finally, two subgroups were identified, one with isolated or no systems abnormal and a second (in 30%) with multiple systems abnormal. The latter group was independently associated with being frail (OR = 2.6, p < .05), adjusting for confounders and chronic diseases and then controlling for individual systems. CONCLUSIONS: Overall, these findings indicate that the likelihood of frailty increases nonlinearly in relationship to the number of physiological systems abnormal, and the number of abnormal systems is more predictive than the individual abnormal system. These findings support theories that aggregate loss of complexity, with aging, in physiological systems is an important cause of frailty. Implications are that a threshold loss of complexity, as indicated by number of systems abnormal, may undermine homeostatic adaptive capacity, leading to the development of frailty and its associated risk for subsequent adverse outcomes. It further suggests that replacement of any one deficient system may not be sufficient to prevent or ameliorate frailty.
机译：背景：老年人的虚弱，被定义为星座和症状，与个体生理系统的异常水平有关。我们检验了以下假设，即生理系统异常的临界质量与脆弱性相关，并且超出每个单独系统的状态，并且这种关系是非线性的。方法：使用来自妇女健康与衰老研究I和II的70-79岁女性的数据，多种分析方法通过八项生理指标评估了虚弱的横断面关联。结果：每个系统的异常（贫血，炎症，胰岛素样生长因子-1，脱氢表雄酮硫酸盐，血红蛋白A1c，微量营养素，肥胖和精细运动速度）均与体弱状态显着相关。但是，根据每个系统度量的水平进行调整，系统的平均数量会显着受损，并且非线性地预测脆弱性。具有三个或三个以上系统受损的系统最容易出现虚弱，随着系统数量处于异常水平，虚弱的几率会从4.8到11至26的比值比（OR）从1-2，3到4的那些比值，以及五个或更多系统异常（所有p均<0.05）。最后，确定了两个亚组，一个亚组孤立或没有系统异常，另一个亚组（占30％）是多个系统异常。后一组独立地与体弱相关（OR = 2.6，p <.05），针对混杂因素和慢性疾病进行调整，然后针对单个系统进行控制。结论：总的来说，这些发现表明，脆弱的可能性与生理系统异常的数量呈非线性关系，并且异常系统的数量比单个异常系统更具预测性。这些发现支持了这样的理论，即生理系统中随着年龄的增长而导致复杂性的总体丧失是脆弱的重要原因。暗示是，阈值复杂度的丧失（如系统数量异常所表明的那样）可能会破坏体内稳态的适应能力，从而导致身体虚弱和随之而来的不良后果风险。它进一步表明，替换任何一个缺陷系统可能不足以防止或改善脆弱性。

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