title: Inflammation, adiposity, and mortality in the oldest old.
abstract: BACKGROUND
  Increased proinflammatory status is associated with both increased adiposity and higher mortality risk. Thus, it is paradoxical that mild obesity does not predict increased mortality in older adults. We investigated the association of inflammatory markers with body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) in nonagenarians, and the combined effects of BMI, WC, WHR, and inflammatory status on mortality.
  
  
  METHODS
  This study was based on a prospective population-based study, Vitality 90+, carried out in Tampere, Finland. Altogether, 157 women and 53 men aged 90 years were subjected to anthropometric measurements, blood samples, and a 4-year mortality follow-up. Inflammatory status was based on sex-specific median levels of interleukin-1 receptor antagonist (IL-1RA), interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-α (TNF-α).
  
  
  RESULTS
  In the unadjusted linear regression analyses, IL-1RA, CRP, and TNF-α were positively associated with BMI and WC in women, whereas in men IL-1RA was positively associated with BMI and IL-6 positively with WC. In the models adjusted for diseases, functional status, and smoking, IL-1RA and CRP were positively associated with BMI and WC in women. Low WC and WHR combined with low inflammation protected from mortality in women and high BMI and WC regardless of inflammation protected from mortality in men in the adjusted Cox regression analysis.
  
  
  CONCLUSIONS
  In the oldest old, the effect of adiposity in combination with inflammatory status on mortality differs between men and women. More research is needed to disentangle the role of adiposity among the oldest old.
authors.affiliation: Gerontology Research Center, School of Health Sciences, University of Tampere, Finland. inna.lisko@uta.fi
authors.forename: Inna
authors.initials: I
authors.lastname: Lisko
authors.forename: Kristina
authors.initials: K
authors.lastname: Tiainen
authors.forename: Sari
authors.initials: S
authors.lastname: Stenholm
authors.forename: Tiina
authors.initials: T
authors.lastname: Luukkaala
authors.forename: Mikko
authors.initials: M
authors.lastname: Hurme
authors.forename: Terho
authors.initials: T
authors.lastname: Lehtimäki
authors.forename: Antti
authors.initials: A
authors.lastname: Hervonen
authors.forename: Marja
authors.initials: M
authors.lastname: Jylhä
mesh_terms: D050153:Abdominal Fat / Q000378:metabolism; D050154:Adiposity; D000367:Age Factors; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001823:Body Composition; D015992:Body Mass Index; D005260:Female; D005387:Finland; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D016014:Linear Models; D008297:Male; D009026:Mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012737:Sex Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio
chemical_list: D015415:Biomarkers