title: Association between interleukin-6 and lower extremity function after hip fracture--the role of muscle mass and strength.
abstract: OBJECTIVE
  To examine whether an effect on muscle mass or strength explains the association between interleukin-6 (IL-6) and lower extremity function in the year after hip fracture.
  
  
  METHODS
  Analysis of data from a longitudinal cohort study.
  
  
  METHODS
  Two Baltimore-area hospitals.
  
  
  METHODS
  Community-dwelling women aged 65 and older admitted to one of two hospitals in Baltimore with a new, nonpathological fracture of the proximal femur between 1992 and 1995.
  
  
  METHODS
  At 2, 6, and 12 months postfracture, serum IL-6, appendicular lean muscle mass (aLM), and grip strength were measured, and the Lower Extremity Gain Scale (LEGS), a summary measure of performance of nine lower extremity tasks was calculated. Generalized estimating equations were used to model the longitudinal relationship between IL-6 tertile and LEGS. Whether muscle mass or strength explained the relationship between IL-6 and LEGS was examined by adding measures of aLM, grip strength, or both into the model.
  
  
  RESULTS
  Subjects in the lowest IL-6 group performed better on the LEGS than those in the highest tertile by 4.51 (95% confidence interval (CI)=1.50-7.52) points at 12 months postfracture. Adjusting for aLM and grip strength, this difference was 4.28 points (95% CI=1.14-7.43) and 3.81 points (95% CI=0.63-7.00), respectively. Adjusting for both aLM and grip strength, the mean difference in LEGS score was 3.88 points (95% CI=0.63-7.13).
  
  
  CONCLUSIONS
  In older women, after hip fracture, reduced muscle strength, rather than reduced muscle mass, better explains the poorer recovery of lower extremity function observed with higher levels of the inflammatory marker IL-6.
authors.affiliation: Division of Gerontology, Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, Maryland 21201, USA. rrmiller@epi.umaryland.edu
authors.forename: Ram R
authors.initials: RR
authors.lastname: Miller
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Shardell
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Hicks
authors.forename: Anne R
authors.initials: AR
authors.lastname: Cappola
authors.forename: William G
authors.initials: WG
authors.lastname: Hawkes
authors.forename: Janet A
authors.initials: JA
authors.lastname: Yu-Yahiro
authors.forename: Jay
authors.initials: J
authors.lastname: Magaziner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D005260:Female; D018737:Hand Strength; D006620:Hip Fractures / Q000097:blood / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D008137:Longitudinal Studies; D035002:Lower Extremity; D018908:Muscle Weakness / Q000097:blood*; D009133:Muscular Atrophy / Q000097:blood*; D020127:Recovery of Function
chemical_list: D015850:Interleukin-6